Miscarriage is estimated to occur in 50% of pregnancies, and at one time, mothers were often unaware they were even pregnant when this was experienced.  With advanced technology and early-detected pregnancy kits, the awareness of pregnancy loss often happens much sooner.  Among all the difficult moments families experience pregnancy loss experience, one that is so common to doula care is a pregnancy loss when the mother doesn't yet have established prenatal care.

For obstetricians and hospital based care providers, it is typical for mothers to be refused an appointment until after 6 weeks gestation.

For many home birth midwives, it is typical for mothers to not receive prenatal care until 20 weeks gestation.

What are mothers doing on their own without support who are experiencing early pregnancy loss, or simply need questions answered, prior to this time?  The amount of contacts I receive from mothers who are stressed because they can't find a care provider that will provide care to them based on them as a person, rather than them as a gestational age, is astounding.  Many of these mothers go on to finally reaching the point in their pregnancy where someone will provide prenatal care to them, but quite a few are either experiencing some sort of symptom that has them alarmed or just need more love and guidance during the early parts of pregnancy.

At 6 weeks gestation, it is common for moms to experience some of the most intense emotions of a new pregnancy, including, but not limited to:

• High Anxiety
• Hormonal Fluctuations
• Spotting
• Bleeding (or threatened miscarriage)
• Abdominal Pain
• Nausea (sometimes severe)
• Fatigue
• Influences of nutrition, including caffeine intake and even alcohol, tobacco, and drug use
• Plethora of questions and What If's

By 6 weeks gestation, the baby has gone through a dramatic developmental growth, though only :

• Neural Tube that will direct the growth of the entire nervous system
• Beginning of the arms & legs
• Beginning of facial features including the beginning of eyes and inner ears
• Liver & Kidneys
• Lungs
• Heart, which begins beating around 5 weeks

I'm Experiencing a Miscarriage at Home

If you're experiencing pregnancy loss, especially before a care provider has scheduled a visit with you, what can you do?

Call for Support

Get in touch with someone, anyone, that can help support you emotionally, and physically as needed.

• Doula - You can get in touch with me through this website or at www.facebook.com/EsaliBirth
• Bereavement Doula
• StillBirthday.com
• NowILayMeDownToSleep.org
• SufficientGraceMinistries.org

What Will I Experience During Early Pregnancy Loss?

Gestational age influences your experience quite a bit.  Emotions will play a significant role in the intensity of labor that you may feel as well.

• You will feel crampy, at minimum, and typically will experience stronger contractions the older your baby is
• It is OK to feel sad no matter how early you experience a pregnancy loss
• It is also OK to not feel sad, just be sure you're expressing your emotions and not holding them in
• Rest, nourish yourself, have people care for you while your body heals and lochia (postaprtum bleeding) subsides.  You are not likely to experience any breastmilk prior to about 20 weeks gestation.

What do I do During Early Pregnancy Loss?

• Call your support person(s), doula, family, friends, faith leader or spiritual counselor.
• It is very common for early pregnancy loss to occur on the toilet without anticipation and you may not have had the chance to catch the baby.  If this occurs, you can create a ceremony with dim lights, candles, and notes on tissue paper to flush with the baby or afterwards if you have already flushed.  You may also choose to bury notes, even under a tree, as a memory.
• Visit the Sufficient Grace Ministries Homebirth Miscarriage Guide for a very detailed lists of items you may wish to have on hand and ways that you can support yourself during this time, especially the older your baby is when you experience.

What Can Providers Do to Support Families During Early Pregnancy?

Yes, there are time restrictions in obstetrical practices.  Yes there are distance and financial restrictions in home birth practices.  Hopefully you will find some of these options to be of benefit to you for your care:

• Provide prenatal care for moms no matter their gestational age
• If you are a home birth provider who usually doesn't get reimbursed for this stage of pregnancy, change your service options.  You can offer a more robust perinatal package, or you can offer counseling and support services in addition to your typical prenatal care that often only begins after 20 weeks.  Explain the difference.
• Connect with a doula network, or provide early pregnancy support in your office.  Doulas are great options to fill in these spaces when they can't fit into a provider's schedule.
• Offer phone and messaging support, or virtual (or in-person) support groups for moms in the beginning stages of pregnancy.
• Create a prenatal literature and a website that fills in the gaps for your clients (or potential clients).  Get in touch if you need support developing this material.
• Encourage your clients to reach out to you for questions, and build this into your package, so your clients feel comfortable communicating with you prior to your standard prenatal schedule.

Remember, most of the perinatal experience, from healthy to happiness, revolves around how a mother is treated.  This isn't just during labor and birth, it is from the first moment a family connects with a provider.  All the moments matter.

If you are looking for answers for pregnancy loss or general pregnancy questions, no matter how far along in your pregnancy (or if you aren't even pregnant yet or if you've already experienced miscarriage), please get in touch.  You can find me here on this website or facebook.com/esalibirth is a great way to directly connect with me as well.