It was in the final moments of my eighth pregnancy when I began to shiver uncontrollably

I remember being wheeled into the operating theatre. I started shivering almost immediately, a triple whammy of a reaction to the anaesthetic for my impending caesarean, a cold operating theatre and abject fear.

As I lay there and my obstetrician started to cut me open while I shivered uncontrollably, tears started to trickle out of the corners of my eyes and into my ears, making everything sound very far away. It was an out-of-body experience. I felt like I was floating above the scene, in a bubble of terror and trauma.

More than 150,000 Australian women have experienced a miscarriage.Credit: Marija Ercecgovac

The poor anaesthetist noticed my silent tears and asked if I was OK. My husband very gently tightened his arm protectively around me and said, “She’s OK, it’s just a lot.”

It was the final moments of my eighth pregnancy, but only the second to get past 16 weeks of gestation.

Lying there, so close to having my miracle baby, the trauma of the previous losses had caught up with me. All I could think about was the long list of things that could go wrong, even at this late stage. Those thoughts were crippling.

The birth almost five years ago of my living daughter wasn’t my only birthing experience imbued with trauma. The one I think about most was the one that took place over my toilet and into my own hands, before the baby even had grown toenails.

After launching my book about miscarriage – written for both patients and medical practitioners – I helped set up the Early Pregnancy Loss Coalition.

I wanted to see a sector that’s full of passionate, caring, tenacious leaders pool their strength to advocate for change; because when so many doors get slammed on an issue that seems to make everyone more uncomfortable than any other, it can take an army to break them down.

One of the first tasks our group took on was writing a submission to the NSW Parliament’s Select Committee on Birth Trauma, one of very few that even mentioned loss before 20 weeks. The reaction was almost overwhelming. Messages of thanks flooded in from around the country, grateful we’d ensured miscarriage was included for consideration.

When people think of “birth trauma”, the most common associations are unwanted and unnecessary surgical interventions, terrible and sometimes avoidable birth injuries or stillbirth. All of which are clearly, deeply traumatic.

Not many people think of miscarriage.

This, despite miscarriage being the most common pregnancy “complication”, affecting up to 150,000 families a year in Australia. Not just patients, but partners, grandparents, siblings. Why is it so rarely considered? Even when it is considered, it’s rarely independent of other forms of birth trauma and frequently sits in the back seat.

When a patient is pregnant, they are treated within maternity departments in hospital, however when it’s determined a pregnancy is no longer viable, we’re suddenly the hot potato no one wants, pushed into emergency departments, to GPs or even abortion clinics for surgical procedures to end the pregnancy if it hasn’t ended on its own. Too many patients who turn up to emergency rooms with threatened miscarriage end up giving birth in hospital toilets or waiting areas.

For later miscarriages, where the patient does give birth in a hospital setting, many patients are – somewhat ironically – forced to do so in maternity departments, next to patients who are giving birth to bouncing, healthy babies. The trauma and pain is unimaginable.

Even when patients attend ultrasound clinics due to threatened miscarriage, they’re usually seated in the main waiting area, in a room full of heavily pregnant women.

I don’t think there is a human being on Earth who would attempt to argue that stillbirth is not a loss and a trauma. But there is confusion when it comes to miscarriage. Is it because you’re not left holding a sleeping baby? Is it because sometimes you have only pregnancy tissue or nothing at all to show for your loss?

This is why so many patients who turn up to emergency rooms with threatened miscarriage end up giving birth in hospital toilets or waiting areas.

Trying to break down doors consistently being slammed in your face, because a topic isn’t “palatable” takes its toll.

But the wins keep us going.

It is the work of the Early Pregnancy Loss Coalition (we are all volunteers) and our members that resulted in the government this year committing to Australia’s first untied federal budget spend on miscarriage education, support and research.

More than that, it’s the first time an Australian government has named the most common pregnancy complication as something of priority. A standalone issue that deserves our attention.

As with any trauma, birth trauma can affect a patient’s entire wellbeing, not just in the aftermath of the event, but for years, even a lifetime, after.

We can and must acknowledge all trauma, even the ones lesser understood. Even the ones that make people uncomfortable.

Perhaps those ones most of all.

Isabelle Oderberg is a journalist, commentator, media professional and author. She is the chair of the Early Pregnancy Loss Coalition. Her first book is Hard to Bear: Investigating the science and silence of miscarriage.

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