Why it is important to support women in the first trimester of pregnancy
And how as part of this we can support early goodbyes
And can we find a word other than “miscarriage” – “early baby loss,” “early pregnancy loss” or “early birth”?
I am writing this blog in 3 parts, so that you can have time to reflect and share your thoughts and ideas, which I can include in the next 2 posts. Please share these through the Substack comments, because then others can read them and it also lets Substack know that people are engaging with my work.
This first part is exploring why both women and therapists are wary about bodywork in the first trimester because of the relatively high incidence of early loss. Yet this is an important time to support women and babies and I would encourage women to get the support they need in the first trimester.
The second part will go into more depth on why only 40 to 60% of fertilised eggs make it to being born at term and what happens during pregnancy loss.
The third part will explore thoughts and ideas on how we can support the first trimester with bodywork including how we can support women who are losing their baby.
You might also want to watch the class I ran recently on supporting women in the first trimester of pregnancy.
I am writing this in the hope of opening up the conversation around losing a baby during any stage of pregnancy but especially so that women can access the support that they need during the early stages of pregnancy. This support is often lacking because many therapists and yoga teachers are afraid of working with women in the first trimester and potentially causing early loss. And many women are unsure what will be helpful or not. I want to encourage therapists to reflect on why they might be afraid, but also to know that, as long as you work with each woman as an individual and support their energy you can only be helping both mother and baby in these early stages, whatever the outcome. And yes, we need to remember that some women will have to say goodbye to their baby during these early weeks, but our work can support them in that process too!
I’d love to continue the conversation so please comment with your thoughts and ideas.
And if you like this Substack please share it with your friends and colleagues!
Many women experience early pregnancy loss
Losing a baby, at any stage of pregnancy is painful. Everyone has a different experience, but one thing that links all women is the pain of not having their children with them.
“the grief I experienced of losing my baby was beyond anything I thought I could feel”
Over the years, I have supported many women, either currently going through the process of losing a baby in the first trimester of pregnancy, or processing the grief and the memory of a previous pregnancy loss or termination. Many of these women have experienced several losses, some even as many as 5 or more. These unprocessed losses may be creating difficulty with conceiving, menstrual cycle issues including in the perimenopause as well as issues with their relationships. Yet it is still a topic many women don’t feel they can talk about openly and can stop women accessing the support they need during the first trimester.
The words that we have seem very inappropriate. Words like “miscarriage” imply that something wrong has happened, like miscarriage of justice. In my book “ Pregnancy and childbirth:”
I used the term miscarriage, but wouldn’t if I were writing it today. I tend now to use the terms "early baby or pregnancy loss" or "early birth" instead of “miscarriage” because women are birthing a baby. These terms are better than "miscarriage" but I still wonder if there could be a better term. In French, the words are even worse “fausse couche” : a fake layer.
Many women feel guilty that they may have done something to cause early baby loss
Many women feel anxious during their first trimester because they know that the chance of losing their baby is relatively high. They may stop doing activities which could enable them to relax and nourish themselves and their baby, like yoga and receiving shiatsu or massage. They may even decide that they don’t want to connect with their baby just in case they lose them. Yet the baby IS aware, perhaps even before conception. By 7 weeks its sense of touch has already developed. Imagine how it must feel to be ignored by your mother? The person you most depend on. I had a Mexican student in a class the other week and she said she found it odd how in France women don’t want to tell anyone they are pregnant in the first trimester. In Mexico they celebrate the arrival of a new life, while being aware that it may only chose to stay for a short while.
Many therapists are also worried about working with women in the first trimester.
It's important to understand that there is nothing in our work which would create an early loss. I often remind my students, that if it was that easy then why don’t women induce their own terminations using acupuncture points or strong yoga postures? Shiatsu and yoga are powerful, but not that powerful! If the baby is developing well, its life force is strong and not much can interrupt it. We all know of women who have been involved in car accidents or in violent relationships and have suffered acute abdominal trauma and sometimes the baby survives.
Why is so difficult to talk about it?
It is complicated. It involves deciding when and how life begins. Many ancient cultures acknowledge that the soul of the baby is present before it decides to take on its physical form in this world with these parents. The baby has its part. I, like some of my clients and students, felt the energy of both of my children around me before I conceived. Indeed with Rosa, my firstborn, I felt that this was a new form of natural birth control! Yet while consciously I didn’t feel ready to become pregnant, and felt I was saying “no,” I must have been unconsciously inviting her in. She is now 34 and is a yoga teacher and massage therapist, specialising in pregnancy, birth and postnatal clients and assists me on the pregnancy massage courses.
If we accept that life begins at least at the moment of conception, then how do we justify taking this life? For some women it clearly is not the right time and they need to say no to their baby. They may later feel guilty for having ended a pregnancy, especially when they may naturally lose a baby in a subsequent pregnancy. I love the work of David Chamberlain, who, in his book “Windows to the Womb” gives examples of souls of babies acknowledging that the mother wasn’t yet ready to carry a baby to term and understanding their need to have a termination. It’s asking a lot for a woman to give over her body physically for Some souls come back to the same mother when she is ready and others move on to another mother. 9 months and then indeed for the rest of her life to support this new life.
People are beginning to talk about it more and books like David Chamberlain’s and “Beyond Grief: Navigating the Journey of Pregnancy and Baby Loss” by Pippa Vosper are helping with our conversations. The NHS (National Health Service) in the UK now issues a baby loss certificate for babies born before 24 weeks.
https://www.gov.uk/request-baby-loss-certificate
I love the practice in Japan of having a graveyard in Tokyo, the Zojo-ji Temple, where people have statues for all early baby losses - Jizo Statues
Acknowledging loss as part of a woman’s life cycle and giving space to grieve
While many people feel that losing a baby means something is wrong, we need to be aware that many fertilised eggs don’t make it to a full term baby. Our body prepares us for this. Most of our eggs don’t even make it to ovulation and of those that do many don’t get fertilised. Menstruation gently prepares us for the releasing and loss of a potential life.
Is there anything I can do to prevent losing my baby?
I think understanding the complexity of what happens may help put this in context. The answer is maybe, maybe not! Of course it is important to do what you can to support your emotional and physical wellbeing. Preparing your body for potentially 9 months and more of demanding work is essential. Eat well, stop smoking and drinking alcohol, move, work on any stuck emotions especially any which impact your relationship with your partner, reduce stress, avoid toxins in the environment as much as you can. The ancient Chinese said that the quality of the egg, and, for the father, the sperm, is the most important inheritance you can give your baby. However, they also believed that the soul of the baby chooses its parents and that some people are not destined to become parents. Do what you can but try to accept that you cannot control everything. Instead focus on opening up and allowing life to flow through you. Although I believe that shiatsu and self-care can offer powerful tools to support conception and pregnancy, I never promise my clients that they won’t lose their baby. I don’t know. It is truly a journey into the unknown where we may meet new life or we may experience death.
It may seem unfair at times. I have worked with clients at high risk in pregnancy in hospital where they have done everything they can to prepare and yet in the next bed lies a drug or alcohol abuser who is about to give birth to their 5th baby who they have to give up for adoption.
Losing a baby early in pregnancy is, sadly, a common reality and much of the time there is not much we can do about it. Death is ever present in life. Like all the acorns an oak tree drops which do not grow into oak trees, most human eggs do not develop into babies. Like the acorn, the eggs journey is long and perilous and few survive. The journey is especially difficult in the first trimester and there are several phases when it can end.
I will explore the journey of the baby in the first trimester in the next blog. Meanwhile I look forward to your responses and carrying on the discussion.
References and further reading:
Early embryo mortality in natural human reproduction: What the data say:
Gavin E. Jarvis 2016
Windows to the womb: David Chamberlain
Beyond Grief: Navigating the Journey of Pregnancy and Baby Loss: Pippa Vosper
Dear Nabeela, Thank you for your thoughtful response. I agree entirely. Allopathic medicine tends to view the physical and negative aspects of our being. That's why I love Traditional Chinese medicine so much!
And I agree about how we need to allow parents to lead the conversation and let them decide what is best for them. As you said never say "you can have another baby".. we can never replace a lost baby, whatever their age. Also it is important not to say "well at least it was early on"...it is always a life, a baby.
And yes with "stillbirth", another not very lovely term, babies older than 24 weeks, I tend to now say "later baby loss" women are still encouraged to spend time with their baby if they want. And I agree often holding a funeral is important.
Do you have any thoughts on words to use?
Thankyou for your wonderful thoughts.
I trained as a midwife in 1986 and have never thought about the word miscarriage and the message it sends. Like many terms in Allopathic Medicine it seems to have been coined considering only the physical and negative aspects of a bodily function. The Professor of obstetrics at my training hospital (in Australia), used to say birth is a purely physical process. He would not entertain the idea there are other forces involved. The power of mother's/women, the spiritual aspects, the emotions involved are enormous. Even from a physical aspect to consider the effect of hormones on our emotions, it is obvious birth and pregnancy are much more than a physical process.
It is so important to be available and to invite parents/families to discuss a loss. Frequently we are afraid of such conversations probably because in many societies we are shielded from death, and we are afraid of the emotions surrounding the passing of our fellow humans. Such conversations are always best lead by the parents who are suffering the enormous loss of their child. Sometimes people do not recognise the extent of grief, around early pregnancy loss.
After a stillbirth we used to, (I think it's still the practice), encourage the parents to spend time with their baby, often it would take days of them holding their baby, talking to their baby, touching their baby. Usually they needed a break from the intense experience of having their baby with them. And we would mind their baby for a time.
Holding a funeral is often an important step in the greiving process.
For those not familiar with talking with greiving parents, you probably already know, but I will say it anyway. Please never make light of their loss by saying, "you can have another baby". There will never be a replacement for the loss of their child, the loss of the hopes dreams and expectations that come with the experience.