Originally published on Medium.

Image: Chrissy Teigen shares an intimate look at her immense sadness after losing her baby

When I was ten weeks pregnant, I took a deep breath and posted about it on Instagram. I knew there was a risk I might have to return, tail between my legs, to admit I had miscarried. But that was exactly the point. There’s an unspoken rule to keep pregnancy a secret until you’re in the “safe zone” of the second trimester (twelve weeks). Why? Because miscarriage is common in the first trimester, and we don’t want to have to talk about it. I believe this perpetuates an idea that miscarriage is shameful, that people can’t handle talking about it. Neither of these things are true, so I decided to use my social media platform to model a new kind of behavior, announcing my pregnancy in the first trimester, owning this uncertainty in a public forum.

That uncertainty in the first trimester is very real. As a physician, I’m aware that miscarriage occurs in about ten to twenty percent of pregnancies, and almost all of that risk falls in those first 12 weeks. Understandably, people wait until the risk of miscarriage is considerably lower before they tell the world.

But there’s a problem with this: we rarely hear about the early pregnancies that end in miscarriage. It creates a biased perception that all pregnancies you hear about magically work out. And then, when someone has a miscarriage, they’re left feeling isolated in that experience and suffering in silence. They wonder: what’s wrong with me? Why did this happen to me and not to everyone else? But in reality, it happens so often — we just don’t hear about it. Miscarriage is a last bastion of secrecy and shame. I felt called to put myself in this exposed position so that, in the event of a miscarriage, I could offer up my lived experience to help shift the conversation around miscarriage.

Then, at eleven and a half weeks, I miscarried.

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Women: trust yourselves. Our medical system is subtly and systemically misogynistic (and racist, and fat-shaming, and the list goes on). If you are experiencing something with your health, and you’re met with a dismissive or invalidating attitude from healthcare practitioners, do not let this make you shrink into shame or silence. Trust your body. And anytime something smells like b.s., speak up, push back, advocate for yourself. Rather than questioning yourself, question the system.

Marshall Rosenberg introduced me to the concept of a true “yes” and true “no” in Nonviolent Communication. If someone asks you to do something, and you can hear your body whisper “no”, but you hear your mouth say, “yes,” you are giving your false yes. We do this to avoid confrontation and to avoid disappointing people. Especially for women, we’re conditioned to say yes, people-please, and meet the needs of all of those around us without regard for our own personal truth. We might even be out of touch with our needs and energetic limits. Next time, try to muster up your true no. They may protest or be disappointed. Do it anyway. You don’t need to justify it (that’s just you doubting yourself). Begin the powerful practice of honoring your own truth. The surprise ending to this story is that it ends up being kinder to those around us than betraying ourselves to do whatever is asked of us.

Borderline personality disorder is one of those things we’re taught is fixed and life long. It also carries stigma. Meanwhile, it has a higher prevalence in younger women than in older women, so is it really so fixed and life-long? As with all aspects of mental health, I believe people can change. Borderline personality is often a maladaptive but understandable set of coping strategies that form in the context of chronic trauma in childhood or adolescence (that’s why there’s a push to rename this condition complex PTSD).

I’m no stranger to the fact that our medical system is broken, but every time I engage with it, I feel renewed outrage. As a physician and a recovered people-pleaser, I’m well-positioned to advocate for myself. Yet still (!), I felt dismissed and subtly bullied by the systemic misogyny and adversarial attitude peppered throughout the medical system.

I also learned that the medical field has a poor understanding of what a body needs after miscarriage. My body was screaming for naps, baths, bone broth, soup, and gingersnap cookies. Instead, the medical advice I got was to run around the city to get additional sonograms, blood tests, and IV fluids. The morning after a miscarriage! I didn’t need IV fluids in an ER gurney, I needed to sip tea while lying on a couch under a blanket watching Jane The Virgin.

After an enlightening conversation with Kimberly Johnson (author of The Fourth Trimester), I learned that the time after miscarriage is essentially a post-partum period, but without a tradition of rest and time off from work (at least in our culture; and the U.S. barely understands the necessity of this even after childbirth, but that’s a separate conversation). She also recommended vaginal steaming to help my body heal.

If you’ve experienced a miscarriage, give yourself time to rest, stay out of gravity (standing, unnecessary activity), consider vaginal steaming, and nourish yourself with iron-rich foods like pate, bone broth, nettle tea, red meat, spinach, & blackstrap molasses, along with citrus fruits for vitamin C. Floravital can be a helpful supplement.

Give yourself space to process, and welcome all feelings, whether it be sadness, grief, defeat, anger, rage, relief, ambivalence, questioning your faith, or deepening your connection to the divine.

Trust what your body is asking for and, within reason, question the knee jerk medical advice. My follow-up sonogram can wait a couple days (I already had one in the ER to rule out ectopic pregnancy, a true medical emergency). For now, my focus is on rest, nourishment, and turning inward to process this experience.

Sunday night, I miscarried.

A week ago I announced my pregnancy. I did this to normalize talking about pregnancy in the 1st trimester so: women don’t need to hide that they’re tired and nauseated, and–if and when a miscarriage happens, it’s not a shameful secret. Women don’t have to suffer in silence, and we can begin to understand just how common miscarriage is.

I knew I was taking exactly this risk, that there was a chance the universe would call my bluff. Was I really comfortable talking about this? Well, here are some rough draft reflections:

I’m not actually devastated. It almost feels like I’m supposed to be. Yet, I feel okay, and I’m letting myself be okay with feeling okay. In no way do I mean to discount anybody’s immense sadness after pregnancy loss. That is truly understandable. But I also need to be honest, and I want to give people license to feel however they feel. There’s no right or wrong. I have a daughter, my life is full, I know that my body has already given birth to a healthy child, I trust that it probably can again, and I love my body and myself even if I no longer can. My worldview, which has been shaped by grief and ecstasy alike, is to surrender and trust this journey that feels vastly beyond my conscious understanding. I can understand how someone might feel worried they’ll never have a baby, can believe there’s something “wrong” with their body, and can feel an unimaginable sense of defeat after multiple pregnancy losses. At the very least, my hope is that we can all drop the shame and self-blame, and that miscarriage can serve as a call to action to get quiet and ask your body what it needs. But also, miscarriage happens even when your body already has what it needs. Miscarriage happens, full stop. It’s a part of the childbearing journey. It’s part of the “full catastrophe” of being human. This understanding helps me feel less attached and less devastated.

If you have experienced pregnancy loss, my whole heart to you. I hope in some small way this post can give you comfort and new ways of understanding what so many of us go through.

I’m pregnant. Ten weeks pregnant. Typically, people don’t announce their pregnancies until they’re in the “safe” zone of the 2nd trimester (12 weeks), because there’s a lot of uncertainty in the 1st trimester. Miscarriage is common: ~10-20% of pregnancies. So people wait until the risk is lower before they tell the world. But there’s a problem with this: we rarely hear about the early pregnancies that end in miscarriage. It creates the illusion that all pregnancies you hear about magically work out. And then, when women have a miscarriage, they’re left suffering in silence. They wonder: what’s wrong with me? Why did this happen to me and not to everyone else? ⁠
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But in reality, it does. Miscarriage is so common, yet it’s a last bastion of secrecy and shame. While we work to blast away any residual shame around mental illness, let’s go ahead and add miscarriage to the mix. It’s not shameful; it’s common, natural, and normal. It’s mother nature’s version of genetic screening. It can happen to anyone. And it’s tough, on a physical and emotional level. So I’ve decided to use my platform to announce my pregnancy. Not because I necessarily want the world to know this personal detail of my life, but because I want to model announcing early pregnancies. If I miscarry, as much as that will be physically and emotionally difficult, I will again use my platform to talk through that experience. If you’re early days pregnant too, consider letting a few people in on your secret. See how it feels to welcome them into the excitement and uncertainty. And if you miscarry, if it feels okay, talk about it. Let people support you. And remember there is zero shame in miscarriage. These things are hard enough without shame. ⁠
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To any patients reading this, I hope you will understand my telling you this way. Since it is so early, we have a lot of time before anything changes.⁠