October is National Pregnancy and Infant Loss Awareness Month and so as part of raising awareness and educating the public about miscarriage, stillbirth, and infant loss, my posts this month reflect this theme.
For many couples, it’s an unfortunate fact that miscarriages tend to go hand in hand with fertility treatments. While many studies show that pregnancies through IVF don’t have any greater risk of miscarriage than naturally conceived pregnancies do, sometimes it can feel as if they do, given how closely IVF pregnancies are watched and monitored.
And while any kind of pregnancy loss is devastating, it can be particularly difficult to go through a miscarriage as an intended parent because of the third party involved in your pregnancy - your gestational carrier. Since she was the one who was pregnant, she must now endure the physical and emotional aspect of her pregnancy loss and it can be a hard to know how to ease the way.
Of course there’s no one best way to handle a miscarriage during surrogacy, but here are some tips to help ease the way through this painful and stressful time:
- Remind yourself (and your surrogate, if need be) that no one is at fault for the miscarriage, no matter how hard it is to accept. Your gestational carrier should have a proven history of conception and successful pregnancy and birth, so it’s highly unlikely there was anything on her part that caused the loss. With gestational surrogacy, the most common cause of miscarriage is chromosomal abnormalities.
My experience – Although I’d never had a miscarriage with my own children, both times I had a miscarriage, I wasn’t surprised because the intended parents had also had many miscarriages of their own, which points to chromosomal factors as a likely cause.
- Rest assured that your surrogate mother does not blame you for the miscarriage either. Nothing could be further from the truth, even if the pregnancy ended due to chromosomal issues with the embryo. Any well-screened and emotionally stable gestational carrier knows there is always a risk of miscarriage with IVF and although it’s difficult to go through, she knows it can be part of the process.
My experience – I was surprised that I didn’t experience my first miscarriage until my seventh pregnancy, given how common they are.
- Take the time you need to initially process the news before talking to your surrogate mother. If you’re overcome with grief when you find out about the loss, take some time to work through your initial feelings and calm down a bit. If you’re concerned about not being in touch with her right away, send a quick text or email that says “I’m thinking of you and I need a little bit of time before I call you, but I’ll call you as soon as I can.” This lets her know that you still care about what happened, but that you need to process it for bit so you can better support her. While it can be therapeutic to cry together, it’s not very helpful if you’re so upset you’re not in control of your emotions.
My experience – I had my doctor call my intended mother to tell her that the baby no longer had a heartbeat, and she called me about an hour later, which was for the better because we’d both had some time to let the news sink in before we talked.
- Don’t be surprised or offended if your gestational carrier does not seem as upset as you are. Everyone processes loss differently, and she may still be trying to come to terms with it. Or it’s possible that she wasn’t surprised by the miscarriage, since some women get a feeling that something’s not quite right in the days or weeks preceding a loss. Your surrogate may also be temporarily more preoccupied with what comes next for her physically than she is about the loss, or she may have been through this before and be able to better take it in stride.
My experience – When I had my second miscarriage, I knew at least a week before the appointment that the baby wasn’t going to make it, it was just a feeling I had, so when the ultrasound tech didn’t find a heartbeat, I wasn’t surprised. I was actually a little relieved that there was a reason behind my suspicions.
- When you’re both calm and clear-headed, discuss what, if any, medical procedures need to be done. Your gestational carrier will immediately stop her estrogen and progesterone and depending on the situation, will schedule a D & C with her doctor or will wait for the bleeding to start (if she’s not bleeding already). If she has the choice between having a D&C or waiting for a natural ending to the pregnancy, support her preference.
My experience – My first miscarriage was losing one of twins, so the baby was reabsorbed as the pregnancy continued with the surviving twin. With my second, I decided to wait for the bleeding to start in hopes of avoiding a D&C. It took over three weeks for the bleeding to start (which was a little nerve-wracking, for sure!), but I’m glad I was able to avoid surgery.
- After the miscarriage, be in touch with your surrogate mother but on the other hand, don’t smother her with attention. While you’re both healing emotionally, your gestational carrier is also healing physically and it will take some time for her hormones to return back to their pre-pregnancy levels. Let her know that you’re there for her if she needs anything and try not to feel offended if she needs a little time and space for as she heals and her hormones drop to their pre-pregnant levels.
My experience – I always appreciated when my intended parents sent me something that my whole family could enjoy, like a fruit basket. Yes, I was the one physically going through the miscarriage but my family was also supporting me at home, so I liked that they felt appreciated as well.
- Once the initial shock and trauma of the miscarriage has passed, don’t be afraid to talk about what comes next for your surrogacy journey together. Whether you have frozen embryos to use or you’ll be starting a fresh cycle or something else, your gestational carrier will probably appreciate having a new plan to look forward to. After all, she wants to carry a baby for you, and the miscarriage is just a stumbling block on the way to making your dreams come true.
My experience – I lost a baby in late October but didn’t have the miscarriage until mid-November. During this time we agreed that we’d wait out the holidays and do another frozen transfer in January. This was a relief to me so that I didn’t have to schedule appointments over the holiday season, but having the plan in place gave us all something exciting to look forward to in the new year.
If there’s one thing that’s universally true about miscarriage after an IVF cycle, it’s that it’s a painful ending to a very much wanted pregnancy. As an intended parent, it can feel especially difficult because it’s hard to watch another woman go through something so sad and painful as she helps you become parents.
Yet while it is hard for your gestational carrier to endure a miscarriage, she also knows that unfortunately, sometimes it’s just a natural part of the process. Once she’s recovered and you’ve had time to come to terms with your loss, it’s important to lean on each other for support and make plans to move ahead on your fertility journey together.