Truly Holistic Miscarriage Support

There is an odd juxtaposition when it comes to miscarriage or infant loss. It’s been normalized by the recurring stat that many of us are exposed to 1 in 4 pregnancies end in loss. Yet, simultaneously, the actual physiology of miscarriage is swept under the rug or dismissed, as is the grief journey that often follows. 

Women are left wondering, “If this is not such a big deal and impacts many, why do I feel devastated and like it is a HUGE deal?”  

I can’t tell you how many times I’ve heard women say, “Oh my doctor said it would just be like a heavy period and that’s all.”  

No recommendations for how to heal, no understanding of what to truly expect with blood loss, no talk of what to do for leaking breasts with no baby to feed, just get on with it. That’s what sets the tone for many women experiencing loss. 

 Even if you haven’t been impacted by loss, you can still learn about it and be willing and able to support women in your community. The skills and knowledge are not hard to learn or implement but they do require deep listening and attunement. And more importantly, a willingness to be with death and grief, something that exists in the shadows of many modern cultures. 

Every loss is unique 

We have to start by understanding that not every loss will be experienced the same way. Of course, a loss at 4 weeks and 5 days of pregnancy will likely (not always) require a shorter healing time and will actually feel more like a heavy period.

However, when we cross the threshold beyond 5-6 weeks, things shift. The baby has had more time to develop and has required more blood supply. The placenta has started to form and perhaps a heart that was beginning to beat, stopped.  

The most common time for a miscarriage to happen is in the first trimester. This is often intelligent but sometimes not - a topic for another time in regards to testing and preventing recurring losses. Here we will focus on how to navigate miscarriage and loss outside the medical model. 

But first, what is offered in the medical model? 

What’s often recommended or offered if someone receives medical care to confirm a miscarriage, is to receive either a medication or surgical procedure. Rarely it will be mentioned that you can take a wait and see approach to see when your body will pass the tissue and fetus but that option is never emphasized as the best choice. 

The medications often used in the USA are misoprostol (prostaglandin-like chemical that induces contractions) and mifepristone (this is becoming more common in recent years and it is a progesterone receptor antagonist - stopping the development of the pregnancy). This method does allow women to be at home for the loss experience and have some agency around timing, which is definitely something to consider. 

The surgical procedure (often referred to as a D&C) does require anesthetic and comes with certain risks like scar tissue in the uterus.

For women who prefer to wait and see or for those who aren’t receiving standard prenatal care, what can they do? 

The true path forward is to trust the timing of the loss experience and know that the body is very wise and will eventually let go. This can be supported in a variety of ways:

• Simple vaginal steaming setup to encourage cervical softening and dilation as well as release
• Create a ceremony or ritual for the woman to begin the grieving process of losing this baby
• Consider working with herbal medicine. Sheng Hua Tang is a common formula to use during the immediate postpartum time as well as for post-loss support. In some cases it may also support initiating bleeding but often something stronger is needed. I typically recommend waiting or starting with steaming and acupuncture but another formula to consider is called Shao Fu Zhu Yu Tang and it is stronger for initiating flow. Shao Fu Zhu Yu Tang is available via Fullscript by Blue Poppy.
• Use castor oil topically over the low belly or low back with some heat. This can encourage the flow of blood as well. 
• Resting, slowing down and orienting towards things that help create a sense of safety are essential. A loss is a birth and it will only happen when the body recognizes a felt sense of safety.

What happens next? What about when blood is flowing or starting? 

Often this is the first sign of loss and can be quite startling or alarming for a woman to experience. Bleeding, while actually quite common in early pregnancy and can be totally benign, is still not generally something we want to see while pregnant.  

If bleeding is either anticipated (loss is known) or moves beyond just occasional spotting then the journey of birthing has begun. Bleeding can pick up quickly or take time, both are normal. It’s helpful to rest, understand that there could be cramping like sensations or uterine contractions just like in birth. Women may need to move around, readjust, take a shower or whatever brings more comfort during this time. 

The most intense hours of a loss tend to be at night but of course it could happen any time of day. It will include fairly heavy bleeding, potentially clotting or the loss of tissue and even a visible gestational sac or fetus. It really depends on many factors.

Many women decide to collect tissue or their baby if that is visible. I definitely encourage this if it’s possible as it can be beneficial for the grieving process to honor this life, this blood and the birth. Having support during the bleeding hours or days that follow can be so helpful. Even if it’s just a phone call or video chat with someone who can hold space for the process. 

Ultimately, there is nothing to do during this part. It’s more about being with the woman, offering nourishment and hydration and allowing emotions to flow with the passage of blood. 

Bleeding may continue for several days or even a few weeks. It should slow down to and eventually find completion. A great way to support this is to use Sheng Hua Tang, a chinese herbal medicine formula that encourages womb cleansing and renewing of Blood. This should be taken for 7-10 days and it can be started once flow has slowed a bit. 

At this point a woman who has experienced loss enters a replenishment phase and postpartum time. 

It’s essential to keep these postpartum healing practices in mind: 

• Increased need for rest and warmth

• Nourishing foods to rebuild blood

• Contact with nature and community 

It’s not a time to jump back into life if at all possible. Even a few days taken to rest and recover can make a big difference in long term health. 

For warmth, be sure to keep the low back, belly and feet warm. You can also add castor oil packs abdominally to create more warmth in the womb space. 

For foods, focus on nourishing broths, soups and stews for at least 7-10 days. Easy to digest foods will support healing and allow the body to also process and assimilate the loss. I love recommending beef stew or chicken soup.  

Surround the mother with beauty in her environment. Bring her flowers, open her windows for a better view and fill the air with soothing music. Again, presence and allowing are an amazing gift during this integration process. 

For physical recovery, I often recommend the formula Ba Zhen Tang, taken alongside motherwort. You can find Ba Zhen Tang by Blue Poppy via Fullscript. Taking this formula for 1-2 months can support the recovery process. 

Many women wonder when ovulation will return.

For most women that I’ve supported over the years, it returns quite quickly. Sometimes within 2 weeks but often within 4-6 weeks. 

But Kristin, what about x…? 

Of course, this is a great overview and starting point for holistic miscarriage support; however, sometimes things do arise. For example, bleeding may be ongoing or come and go. Or a woman who develops a fever and abdominal pain. These can be signs for additional support, not necessarily medical but we all know that is available. 

There are ways to work with herbs, acupuncture and other tools to regulate bleeding after a loss or even address potential uterine infections (which would be incredibly rare for a normal, physiological miscarriage). 

I hope this offers you a window into how to support women who are experiencing loss. It’s an important part of reweaving how we care for each other in community. It can be a monumental right of passage for the woman going through it and she will remember how she was or wasn’t supported during this time. 

Thanks for reading and being a part of the solution.