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When I lost my first baby to miscarriage, I had a deep fear that the world would forget my baby. I wanted my baby to be known, to be seen, to be loved. I resolved that I would carry on the memory of my baby and save a space for this child as part of our little family. I was desperate for this child to have a space. We decided to call our first baby Baby, as that is what we had called the child for more than two months. I decided that I would mark Baby’s due date with a single purple rose each year. This would be a part of our family tradition, even if and when we had living children. I also had carved out space for Pregnancy and Infant Loss Awareness Month and the loss date. I had many plans so that we wouldn’t forget Baby. Then we lost another baby, and another. The ceremonies were getting harder to juggle and seemingly less necessary. Then suddenly, after three losses and two live births, I couldn’t keep straight due dates, birth dates, and loss dates. My four year old has hardly heard me talk about our first three children and I haven’t bought a single purple rose in a few years. It would be easy to feel like I have failed them. But I haven’t failed them at all. What I realize now, seven years after my first loss, is that I will never forget these children. These ceremonial acts were very helpful as I navigated the early days of grief, but I have found a less demanding and rigorous routine that helps heal my soul in this season of life. The memory activities are less scheduled and more free-flowing now. I might purchase purple roses randomly or visit the memory box on accident while cleaning and organizing the bedroom. But this doesn’t mean these children don’t hold a real space in our lives. Instead, they are integrated into my life, much like my living children. I think of them often, not only on their “birthdays.” My fondness never fades and their reality never goes away. Even when I forget the flowers.  Emily Carrington is a freelance writer, wife, mother, and founder of the EPLA.
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“The baby stopped growing. Here is where there should be a heartbeat,” the ultrasound tech told me as I lay on the table, half filled with hope, half expecting another loss. This was pregnancy number six, now a fifth pregnancy loss, a sixth loss in total, counting our foster daughter who passed away unexpectedly at 15 months old. I immediately asked to call my husband. There really were no words, but I needed to let him know. I needed to let someone who understood know. We opted to wait a week for a repeat scan just because I had been here before. I knew my options, and I was nowhere near ready to make a split second decision. I wanted to miscarry naturally if my body would cooperate. At this time, one of our goals was to do genetic testing on our baby to see if we could determine a cause for another devastating loss. After two weeks of waiting, I opted to take Cytotec, a drug that induces labor by softening the cervix to produce contractions. Within six hours, our baby was born. There is nothing more demoralizing and humbling than bleeding and cramping over a strainer on the toilet in the middle of the night. The next morning, after my husband and I had some time to think, talk, and reflect, we realized we really did not want to do genetic testing on our baby. We thought we would bury her, but we were in the midst of winter. We knew our baby would not last long-term in our fridge, and just knowing that fact was traumatic in its own right. I do not even know where I heard about it, but I remember hearing that many funeral homes will cremate a baby lost to miscarriage at no cost to the parents. I talked to my husband about this option, and he agreed with me that this would be the way to go. The first funeral home that came to mind was the funeral home that cremated our foster daughter after she died. We called him, and he expressed his condolences and said he would come to our house that evening to retrieve our baby. The moment he left with our baby, I knew immediately we made the correct decision for our baby and our family. There was a “stillborn fetus” form we had to fill out and sign, but otherwise, it was a simple and healing process for us. It did not take long to cremate our baby. We are still processing, but we know we will find a way to honor our baby and the life she never got to fully live. We are thankful for the funeral home who expressed such kindness and compassion, who offered hope and extended grace. It is healing to have our baby with us instead of not knowing where our baby would be if genetic testing had been done. I am thankful for an option other than flushing. This alone has brought about a semblance of closure, another step to healing, it makes this grief just a tad bit more bearable. Submitted by an anonymous friend of the Early Pregnancy Loss Association.  By Caroline Tomlinson “I was excited. It was the day David was leaving for Finland…I took a test in the morning, and I told him later that day.” Emily and her husband, David, have two beautiful children and were excited to expand their family. Their youngest was just over 1 year old, and they felt like this was the perfect time to get pregnant again. You can imagine her excitement when two pink lines appeared on the pregnancy test. Everything was going well. Nothing was different than in her previous two pregnancies. But about 10 days after her positive test, Emily experienced severe migraines. The pain didn’t raise red flags, as this wasn’t abnormal for her. She had an ultrasound, and the technician assured her that everything was OK. But a few days later, she began experiencing more alarming signs of miscarriage. “I was bleeding a lot and could tell that was it.” Emily lost the baby. This baby is affectionately known in the household as Baby Finn, as Emily’s pregnancy took place during David’s trip to Finland. With each pregnancy, Emily was always cautiously excited because she knew miscarriage was a real possibility. Baby Finn was a beautiful reminder that life is precious and ultimately in God’s hands. Emily and David were fortunate to get pregnant a few months later and have since welcomed two more children into their family. Everyone’s experience is different. Although Emily’s loss wasn’t a physically traumatizing event, she still experienced pain in a different way. “I had a really hard time for at least a month, but I was never angry with God. The biggest thing was…where is my baby now? It was hard to talk to people about it because they would just be like, ‘oh of course your baby’s in heaven,’ but there’s no Bible verse that says that. That was really hard.” Miscarriage brings different pain for each mother. Emily said, “For me, it was not so much healing from the loss of my baby, as it was, can I trust God with the eternal destiny of my children?” Emily didn’t dwell on the loss of her baby. Instead, she wrestled with the hard, unanswerable questions of what happened to her baby. Was her baby in heaven? Will she meet it face-to-face one day? She didn’t know. The month following her miscarriage, her tears flowed as the question remained unanswered. Her husband supported her and encouraged her with scripture. She also received encouragement from her pastor and other mothers who had gone through miscarriages. The encouragement of others, verses in scripture, and the peace of the Lord helped Emily find rest in God’s sovereignty. Those who have not experienced the loss of miscarriage can learn from Emily’s experience. You never know how a mother is struggling with the loss of her baby. She, like Emily, may not be wrestling with anger toward God for taking her baby away. The pain may be different, and that’s OK. Emily also offered another perspective into how she’s doing, years later. “It’s not hard for me anymore…now we talk about Baby Finn, and it’s a sweet part of our family. I feel like there needs to be an acceptance of that, too. I hope I would not be looked at as not caring about my baby, because I’ve been able to rest in that Baby Finn is with the Lord and a sweet part of our family. I wouldn’t want there to be guilt if you’re just OK.” The Early Pregnancy Loss Association seeks to walk alongside women in any stage of grief. For people like Emily, it may not be grief as much as it is unrest and uncertainty. The EPLA understands all women grieve differently, and their mission is to encourage women to speak freely about their loss and pain. Everyone experiences grief differently, and Emily has been able to rest in her belief that her baby is in heaven. Mothers should feel comfortable speaking freely about their miscarriage, whether that be grief resulting in anger or heartbreak leading to peace and rest. Everyone’s experience is different, and that’s perfectly OK.  Caroline Tomlinson is a junior Professional Writing and Information Design major at Cedarville University
By Heather Heritage M.A. The first trimester of my 4th pregnancy was rough. Not only was I exhausted with two young children and working full time, I had severe nausea and dehydration problems - so severe I ended up in the ER on more than one occasion. Most of the questions the ER staff askedwere perfunctory, trying to piece together my condition and background information to get a clear picture for treatment. But when a young physician’s assistant commented on my gestational and pregnancy history, imagine my shock when she bluntly stated, “oh, I see you had an abortion last year.” I had a miscarriage six months prior to that ER visit, and I knew that medical terminology technically classifies any pregnancy loss as an abortion of some sort. But knowing this didn't really take the sting out of her unempathetic words. In the end, I got the fluids I needed and went on my way, but couldn't shake the annoyance of the term “abortion” that was used to describe my miscarriage. Using the word abortion when referencing a miscarriage can be hurtful and alienate the very patients a health care provider (HCP) is trying to build rapport with and treat, even if it is “proper” medical terminology. In the area of early pregnancy loss (miscarriage), there are large inconsistencies in how providers communicate to mothers about the loss they are experiencing, which can result in a lack of thorough treatment and care for these vulnerable patients. A 2019 study explored early pregnancy loss and gaps in the physical, cognitive, and emotional treatment of patients. Using those criteria as a framework, I offer considerations in a triangle of treatment plan for health care providers to use with their patients who go through pregnancy loss. Physical Care The first, and most pertinent point in the triangle, is caring for the physical needs of a patient. In 2019, the American Pregnancy Association reported that one in five women with recognized pregnancies end in miscarriage, making it a fairly common experience. Because of their often abrupt and sudden nature, many women seek help at the emergency room. However, there are significant gaps of care for patients, specifically in the ER, regarding communication, diagnostic testing and follow up instruction. Delays in or failure to complete diagnostic tests occur, specifically with blood work and ultrasounds. In many situations, mothers have left a treatment center without knowing if they had lost their baby, what to expect, and without full comprehension of their condition. Even if the tests are completed, often there are long wait times for results – which could mean leaving a patient for hours, worrying and stressing that their pregnancy is ending. Much of these wait times are due to logistical barriers; however, those delays or obstructions should be communicated and clarified to the patient. There is another gap in treatment: scheduling follow-up visits, which are important for incomplete miscarriages, and cognitive and emotional healing. Often these follow-ups are never discussed or mentioned with a patient. Tips for health care providers caring for the physical point in the triangle of treatment include:
Cognitive Care The second point in the triangle of treatment focuses on cognitive care; specifically, using common terminology, and being able to explain what is happening and give thorough information. There is a need for common language when it comes to early pregnancy loss. Early pregnancy loss means any fetal loss at or before 13 weeks of gestation. This is also referred to as: miscarriage, fetal death, perinatal loss, spontaneous abortion, missed abortion, etc. HCPs need to understand that language and terminology have different meanings to different people, and HCPs need to be aware of this when communicating with their patients. A good tip in getting the terminology right is to use mirroring terms. For example, if a patient uses the term “baby” or “child,” an HCP should mirror their language by referring to the loss in matching terms. Patients also need more in‐depth explanation and communication on the causes of miscarriage, frequency of miscarriage, and their diagnostic test results. HCPs would do well to remember that this is a painful and emotional process for the patient. If a patient is being told the pregnancy is over; all of the hopes and dreams for a viable baby come to a glaring and final halt in that moment. They deserve explanation and information, both in verbal and written communication. Patients and their personal caretakers have said they want more information about physical complications, current treatment, resumption of menstruation, future pregnancies, and emotional health and healing. Tips for HCPs in the cognitive point in the triangle of treatment include:
Emotional Care The third point in the triangle of treatment stresses emotional care for miscarrying patients. There are many opportunities for HCPs to communicate with empathy and offer comfort in bereavement support. Mothers are experiencing shock, sadness, worry, guilt, helplessness, and yet often, there is little empathy provided. In addition, in an ER, there is little privacy, space, and time to process the diagnosis or for providers to simply listen to a patient. More could be done in allowing for the opportunity for mothers to express their grief and emotions. Tips for HCPs in the emotional point in the triangle of treatment include: 1. Encourage patient to talk and discuss their feelings. Give comfort specifically to alleviate feelings of guilt. 2. Encourage sharing of their experience when they are ready. Recommend social groups, websites, blogs, alternative therapies like poetry/art, etc. as it helps in the grieving process. 3. Encourage patients to read prominent stories of women in the public eye who have had a common experience, for example, Chrissy Teigen or Meghan, The Duchess of Sussex. This helps normalize the experience, and patients can find hope in common loss. 4. Understand, practice, and deliver bereavement support in the form of companion care. Dr. Wolfelt, Founder and Director of the Center for Loss and Life Transition defines companion care as:
5. For providers in managerial roles: Consider the use of doulas who specialize in pregnancy loss. A doula is a non-medical person who supports a woman during labor and birth, pregnancy loss, bereavement, and postpartum healing, and are trained to provide one-on-one care, physical comfort, companion care and emotional support. There is often funding via grants or programs that can bring doula care into a treatment center. Caring for the Whole Person Early pregnancy loss is a highly emotional and nuanced situation for each individual. Health care providers are inconsistent in how they communicate to and support mothers going through this sorrow. Understanding these implications would help them treat their patients more effectively, using a triangle of treatment to meet the physical, cognitive and emotional needs of these patients. We’ve all been in highly emotional situations and know that compassion and empathy can go a long way in humanizing the situation. HCPs who implement these suggestions could have a positive impact on grieving mothers for years to come.  Heather Heritage is an Assistant Professor of Communication at Cedarville University.
By Emily Carrington EPLA President and Founder It was late afternoon on a Saturday or Sunday. It was early March, and we lived in Texas at the time. Looking at today’s date, it was probably about seven years ago, give or take a few days. I was starting to make a grocery list and thinking about what we would have for dinner that night. Suddenly I had the urge to take a pregnancy test - because you know, if I was pregnant, I should be focusing on all the good foods and avoiding all the bad foods. (You were my first pregnancy, and there was so much I didn’t know. I certainly didn’t know that by my 5th pregnancy I would be sharing slightly germy/slobbery McDonald’s fries with your sister Abigail and call it a win because I kept some food down! With you the standards started high). Minutes later, I knew you were there! You were inside of me. My first baby. Suddenly I was overwhelmed with all the things I didn’t know. What ARE good pregnancy foods? What about bad foods? How do I take care of this child? I told your dad about you, and he was thrilled! We were so ready for you. We were so glad you existed. We decided on Chipotle because I could load up on some good protein and veggies. That was one of the last decent meals I ate. For a while, only daddy and I knew about you. I remember going to a dinner party with friends and thinking about you the whole time.Every time I passed on the wine or the champagne, I thought about you. During church I nibbled on Saltines, and the woman who sat in front of us figured out you were in there. But most people never picked up on the clues. We were going to keep you a secret for two more months, but we just couldn’t wait anymore. We really wanted to tell your grandparents and your aunts and uncles you were in there. We went to Toys R Us and tried to come up with a cute way to tell everyone about you. We bought the book “Are You My Mother?” and a cute little onesie. We added a piece of paper to the title so it read “Are You My Grandmother?” We then took a picture of the book with the onesie and sent it on to our parents. Then we waited in excited silence for their reply. Grandma and Grandpa were the first to respond. They called confused and unsure what the text meant. I think we woke them up in the middle of a Sunday afternoon nap. When they figured it out, they were so excited! Your Nana and Pop Pop were so excited, too! A few days later we found out your cousin Tucker was on the way. Everyone was so excited you were here, with us. Sadly, we never got to name you. We didn’t know yet if you were an Abigail or a David. It turns out you were neither. We called you Baby and we still call you Baby, because that is the name we knew you by. Your life was so short, and it is often clouded over with grief. But I want you to know I do remember the good stuff, I think of you with so much fondness and joy. I know you were here with us. I know you were real. And I know you are worth celebrating.  Emily Carrington is a freelance writer, wife, mother, and founder of the EPLA.
By: Kathryn Wales Losing my daughter at 16 weeks gestation was a time of both personal breakdown and communal buildup. I could not have anticipated how much my friendships would grow in the torn soil of my soul, or how much my marriage could prosper thereafter. Miscarriage was not talked about much in my social circle until it happened to me, partly because mine came after we had announced the pregnancy publicly and because I was eager to talk in order to process it. Within the span of the following year, 11 of my friends would miscarry, and several of their babies now lie beside mine in a plot tucked inside Notre Dame’s cemetery. Together—without resources or scripts beyond instinct, desire, and hope—we developed a way of grieving such a unique loss. We laid our tiny children to rest in the earth and marked their spots with stone as if we had seen them grow up and had not just felt it; as if we had heard their voices and could remember their smell; as if their names could conjure entire personalities. We did what people have always done for their dead and were immensely blessed to be able to do so. Whenever I visit Theodora’s grave, I see those other surnames and think about those dear parents—our true friends who wept with us, prayed with us, made meals for us, and received all this back in their turn. I send photos of the graves to those who live too far away to visit as often as they wish, and ask how they are faring. They know I mean it in a deeper sense, from our place of shared trauma. And even when there is not world enough and time to reconnect with each other, this special kind of care helps us to reconnect with ourselves. We look at the scar that has become part of our identity. Together, we remember those members of our families who wait for us on the other side. Those particular witnesses are not part of my regular life anymore, save one: my husband. He and I grieved differently in the immediate aftermath and struggled to understand each another’s pain and process. I was desperate to see my own parents, feeling I had to care for them, while he delayed our journey because he could not leave without oiling the wooden wardrobe. Unable to care for our daughter, each of us wanted to care for someone, for something vulnerable. Then we did what we were advised not to do and conceived again as soon as possible, pushing a necessary period of shared mourning far into the future. It was not until another, much later personal crisis in which I called upon my daughter for help did I realize just how much my husband is part of my very self and I can do nothing, signify nothing, without him. Our children are acts of love made flesh, and every act of unlove dishonors their very existence. That is the meaning of marriage. That is family. Rebuilding in the light of that hard won wisdom is the brightest way of being. I recently returned to thank her for the goodness that my husband and I enjoy in this new season of life. I saw my friends’ names and wished them the same new intimacy. The heart is certainly fuller for having loved and lost and loved again.  By: Nick Carrington EPLA Editor Dear Little One, I wonder what your name is. That might seem strange; no one ever gave you a name. You were gone before we knew whether to buy you a blue or pink blanket, and names tend to follow such things. But you’re a person, and people have names. I don’t like not knowing. One of the first things we learn about someone is their name, and in families, we attached meaning to those names. Your father’s name is Adam. I can’t hear that name without thinking of someone who swallows books whole, digesting wisdom and rejecting folly. In our family, the name Adam means “prudence,” but not the unfeeling kind. It’s cloaked in kindness; the upspring of a big heart. Maybe you’re an Adam, too. Maybe you would have read books for hours, unknowingly playing with your earlobe. Maybe you would have found your groove on the junior high dance floor. Maybe you would have tackled some of life’s hardest questions about virtue, liberty, and the brokenness of men. Studious. Fun. Shrewd. But best of all, full of love. But maybe you’re an Emily, like your mother. In our family, that name is synonymous with a relentless will, a will dedicated to goodness and beauty. I would never want to get between an Emily and the task at hand. If you are an Emily, you would have conquered this life through goals and lists, motivated to heal the grief that we only whisper about. You would have harnessed your strong will (with some help from your parents) to attack pain and replace it with peace. You would have brought light to dark places, and rested in the evening with a glass of wine. Strong. Passionate. Good. But best of all, full of love. But I’m guessing you aren’t an Adam or an Emily. You are something between and wholly other. You take from both and make it your own. You may even have a little silliness in you, like your favorite uncle. One day I’ll know -- not just your name, but what it means. Until then, Little One, know that while you never had a name in this life, you still mean so much.  Nick Carrington is an Editor for the EPLA and Associate Professor of Professional Writing at Cedarville University
By Maria Servold EPLA Editor For decades, one of the hardest things to find after a miscarriage was support. In recent years, that has changed. Now, groups like the Early Pregnancy Loss Association and others are working to provide emotional, physical, and mental support after pregnancy loss. EPLA provides information, in the form of resource folders and this blog, as well as physical support, with our miscarriage care kits. Eventually, we hope to help cover the cost of medical bills associated with miscarriage. Another organization providing support is the Star Legacy Foundation. A national group, Star Legacy Foundation is a nonprofit organization that seeks to reduce pregnancy and infant loss, provide support for families after loss, and support research on loss. One of the greatest things Star Legacy offers is a series of support groups, held online via video conferencing. This encourages anyone to participate, no matter their location. Sometimes, the hardest thing to do after a miscarriage is to leave the house and seek support. Star Legacy’s support groups make that hurdle much easier. Support groups cover a range of topics including: pregnancy after loss, dads’ grief, and coping with SIDS/infant death. A list of support group meeting times and registration information can be found here.  Maria Servold is an Editor at the EPLA, Assistant Director of the Herbert H. Dow II Program in American Journalism, and Lecturer in Journalism at Hillsdale College.
By: Stephanie Gordon, EPLA board member and blog editor
Last fall, the Hillsdale College for Life group and the chaplain’s office hosted an event called Rachel Weeping, which was a prayer service of healing for the loss of infant life. The event took place in November at the college’s Christ Chapel. The evening was filled with scripture and prayer to remember those who died in the womb and in infancy. Reverend Adam Rick, Hillsdale College chaplain, led the service, along with some student volunteers. “The background for Rachel Weeping is a service my church in New England put together many years ago to offer a tangible way to grieve within the arms of Christian community and worship for mothers and families who had lost infant children in the womb or shortly after,” Rick said. “It has been offered by this congregation every year since it was first devised. It basically represents a slightly modified funeral liturgy with elements common to various Christian traditions. It was thought this was especially important for women who lost children in the womb because our culture doesn’t generally offer any kind of ceremony to mark this kind of trauma.” Rick led the service, with the help of student volunteers. “A key part of the service is the writing of a letter to the child in which, as the Spirit leads, they call the child by name and commend them to God. The letters are placed on the altar in exchange for a white rose, and afterwards they are destroyed by the officiating clergyman (burned and ashes buried).” Rick said the service was originally proposed by the Hillsdale College for Life group. The service included several members of the club, plus musicians from InterVarsity Christian Fellowship, and prayer teams from both IV and Equip Ministries. Local pastors, both Protestant and Roman Catholic, were present to offer pastoral counseling. “We reached out to local churches and pregnancy resource centers so this service can be a ministry of the college to the outside community as well as to our own,” Rick said. Hillsdale College for Life hopes to make Rachel Weeping an annual event. Kathryn Wales, a Hillsdale local, and mother who’s experienced loss, said she was grateful for the chance to write her daughter a letter. “I had talked to her and prayed with her for years,” said Wales. “But, the prompt to express and submit articulated thoughts and feelings was an important part of my grieving process. I recommend it to any parent who has experienced loss.” By: Emily Carrington EPLA President and Founder “Is the nursery done!?” A woman asked cheerfully at Bible Study. “Oh, no. I guess I have been behind on that. I am not really sure it will be done before she gets here,” I responded politely. “Oh! But you will want a place to put her stuff, and nest! It is just so nice to be organized before the baby gets here. I am sure you will be more motivated soon!” I smiled and was glad the conversation had come to a natural close. I was in my third trimester of my fourth pregnancy. This was the furthest I had ever made it, and I had every reason to believe that our little girl would be joining us in a few weeks. But I couldn’t be sure enough to completely finish her nursery. It wasn’t like I had ignored all of the preparations for the room. We had taken the wallpaper down and painted the walls. I had sorted clothes on a folding table in the corner, and I had thought about where to hang some of the art on the walls. Eventually, my best friend from childhood came to visit, and we spent the weekend washing and sorting clothes. Over the next few weeks I did gain some motivation to prepare more. We put up the bassinet, and we opened some gifts. We bought a car seat and packed our bags. But when we brought our beautiful baby home from the hospital, the nursery was far from done. There was no crib, there was no rocking chair, there were hardly any pictures on the walls. The truth was, I just couldn’t. I couldn’t find the emotional energy to complete a nursery because deep down, I didn’t believe we were bringing home a baby. I did not have gruesome thoughts; there were no medical worries. I had no logical reason to be so pessimistic. But after three pregnancies that seemed to vanish — why should this one miraculously end in a baby? I did not complete her nursery until she was nearly 9 months old. By the time I was done, it was my favorite room in the house, a beautiful room laced with memories, love, and LIFE! Now I see that even though I had lost each of my first three babies in the first trimester, their losses haunted me throughout my whole pregnancy with my daughter. Pregnancy after loss is a unique experience full of unexpected challenges. Well-meaning people may not understand your lack of excitement or preparedness. Luckily, we are not alone. I am thankful for organizations such as PALS that exist to help women walk through pregnancies after loss. Check out their amazing mission: “Pregnancy After Loss Support is dedicated to ensuring that every mom and her partner who is experiencing pregnancy after loss is able to find support and connection among both peers and health care professionals who understand and validate the unique and complex experience of pregnancy after a previous perinatal or child death.” If you or a loved one are struggling with a pregnancy after loss I encourage you to reach out to PALS for support.  Emily Carrington is a freelance writer, wife, mother, and founder of the EPLA.
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