Rosie Phillips • March 31, 2020 • 5 min read
We’re just so sorry that you could not stay.
On Friday 27th March, just days after finding out our baby was dead, still such newcomers to navigating our grief, we met and buried our baby. It was a day like no other I have ever experienced and hope never will again. Medical management of miscarriage is a strange – though necessary, especially in cases like ours – experience. I found the anticipation difficult; to be told you will be forced to contract, my only experience of contractions being full term labour, was intimidating. To be told I could vomit, have diarrhoea, have the shakes, aches in my bones and intense pain was frightening. Why couldn’t it be peaceful? She was so peaceful, still sleeping in the safety of my womb, why could her journey from her only home in me to her forever home in the earth not be as gentle as her death; unnoticed by anyone. I was nervous, but I was ready too. I knew that I could not hold her in me forever.
Jonathan drove me to my appointment and dropped me at the locked doors of the women’s centre. Having something so difficult to accept as real happen in the midst of the Covid-19 pandemic, when the whole world seems surreal, has been all the more strange. I had been told that Jonathan must drive me there and take me home in case I was already feeling the ill-effects of the medication, but he was not to come in. No one other than patients is allowed in the hospital. I entirely understand the necessity of this but it doesn’t make it any less surreal; the doors locked, the corridors entirely empty of visitors and even patients, with any ‘nice to have’ appointments cancelled. Even staff seemed sparse, although I am sure there were plenty around somewhere.
A lady joined me in the lift and we stood at opposite ends. She too had her blue maternity notes tucked beneath her arms. She asked me if I was also going to level 4 and I nodded. She said that she hated how strange this felt without her husband, she just wanted to get into her scan and get out as quickly as possible. I smiled meekly at her. I guess amongst her own anticipation she didn’t see the sadness in my eyes or she wouldn’t have kept talking. When the lift stopped she asked if she could walk with me because she didn’t know where she was going. “We’re not going to the same place.” I said. I still don’t think it clicked for her, wrapped up in her own nerves perhaps. “I don’t know where I am going” she said, “I’ve never been before. Is this not your twelve week scan too?” I shook my head. “I’ll show you” I said.
I walked her – both of us keeping what I hoped was a safe distance from one another – to the door to the reception of the ultrasound unit. I watched her go through wishing so much that was me. I wanted so much for them to check again, to find out there had been a mistake, that my baby wasn’t dead. But I knew that wasn’t going to happen. Tuesday’s scan picture emblazoned on the inside of my mind: I knew I was not wrong. I knew she was dead. I had seen her with my own eyes. I walked back down the corridor and hoped that the woman I had just encountered remained so blissfully unaware. I made a silent wish that over the coming minutes all her dreams came true on the screen before her; I hope she got the good news that every parent deserves.
Much like there is no dignity in childbirth, I have found from this experience there’s little dignity in managing a miscarriage either. Not in terms of the Drs and nurses who I encountered; they were kind and gentle, sympathetic and clear. They took my blood, they spoke to me about the process – “It could be very painful, but we’ll give you painkillers which should help. We’ll give you an anti-sickness tablet, you might still be sick. You’ll contract, you will bleed a lot, watch out you don’t bleed too much, we’ll call you on Friday, you can call us before, too much blood and go to a & e, watch out for infection, try to notice tissue, it might not work and you will have to come back.”
My mind was swimming with facts, with possibilities and with one main concern – it might not work. The thought of coming back and doing it all again was nauseating – and I had not even taken any medication yet. I was told there was a 75% chance it would work first time – I reasoned those were pretty good odds, but then so were the odds our baby would survive and be fit and well, so I wasn’t finding odds to be on my side this week. I nodded that I understood and allowed the undignified part to begin; I swallowed the anti-sickness tablet, the nurse put four pessaries in me (she was kind and did it two at a time – as they have to reach your cervix it is not the most comfortable experience) and I drew the line at her putting the suppository in for me – that I did myself in an attempt to maintain a shred of dignity if possible. I was told to stay lying down for twenty minutes for the pessaries to absorb and then I could leave.
In under an hour they sent me on my way with a pack of codeine, the industrial size maternity pads you use post-childbirth and the plastic-backed square ‘puppy-pad’- esque thing they put beneath you post-childbirth. The painful irony was not lost to me that the last time I had been in the women’s centre with codeine, human puppy pads and enormous maternity pads was post Harry’s birth. Now I had the same items in the same setting, just this time my baby was dead.
Jonathan and Harry had been driving aimlessly around Oxford during the time I was in the hospital, waiting on my phonecall to return. The visitor car parks for the women’s centre are closed. As I left the women’s centre to get back into the car a different woman to earlier stood outside, tears streaming, wrapped in the arms of her partner. I wanted to hug her too. It has become all too apparent that the women’s centre is a building that is filled with the purest love, but also the rawest grief. It is the place where dreams are confirmed, where babies are born, but also the place where hearts are broken: the place where babies die.
We drove home and before the fifteen minute journey was up I was already feeling sick. I went up to bed with my hospital issue pack, my iPad, some tea and some squash and got ready to both welcome my baby and bid her farewell. We told Harry I had gone out for the day so that he would not come looking for me. I didn’t want him to see me in pain or bleeding. As far as he was concerned, baby Olivia was not in Mummy’s tummy anymore. As magically as she had appeared there for him she had left. He does not need to know the agonising truth of how physical the act of letting go is.
It took a few nauseous hours before the pain started. Just like in labour what started as period pains, then really bad period pains, then the worst period pains you’ve had turned eventually into recognisable contractions. What had been blood like a period, then a heavy period, then the heaviest period you’ve ever had turned into an unstoppable bleed. I lay on the ‘puppy-pad’ with my maternity pad on and as my stomach contracted I knew she would not be long now. The pain was intense, but manageable. I didn’t take the codeine, though I probably should have. There’s no need to be in pain. But I thought it might get worse still, I thought I might need it still in time. With my only previous experience of contractions being the birth of my full term, 10lb 6oz son I feared I may have had a long way to go still. The suppository I’d been given in the hospital was a painkiller too, so I suppose without that the pain would have been worse. But just like the doctors had told me it would, it intensified yet again and my stomach tightened with clear intent. It was time to meet my baby.
She was really rather beautiful. I know a lot of people would not have wanted to see their baby at this point and I understand that everyone is different and there is no right or wrong way to react to something like this, but I knew I needed her. I was adamant that I would see her, that I needed to talk to her, to hold my baby for the first and last time.
When she passed out of me I was sure I would cry. In the days between finding out she had died and that very moment all I had done was cry. I imagined that the sight of her would leave me distraught. In reality, that hour or so I spent with her was the only time in the last week where I haven’t been crying or on the verge of doing so. When I was told she was dead my purpose as her mother got lost in my grief. I was supposed to nurture and grow my baby, to carry her safely and deliver her gently into this world. To raise her and watch her flourish. To wipe snotty noses, little tears, to kiss her scabby knees. This had all been taken from me at the first hurdle: to nurture and grow and carry her safely. She had died in the safest place for her, nestled in my womb. Though I know that this is not my fault, I did everything I could to keep her safe and healthy, a small part of me felt like I had failed her.
Now though, I had a purpose once more. As I felt her pass from my womb and into the world at large I did not shed a tear. I picked her up, and cleaned her off a little. She was perfect. I spent a long time just staring at her, taking in every detail of her tiny body; I don’t want to ever forget a single thing about her (I actually took a few photos of her, which Jonathan and I will cherish. They’re so personal to us. I felt they were important; they will really help us to never, ever forget what she looked like, even when we’re old and our memories begin to fade). She had big black eyes. Solid black like coal against the whitest body. She had perfectly formed feet and hands, still slightly webbed if you looked very closely. Her legs and arms were still not quite in proportion like you would expect, but that didn’t make them any less beautiful. She sat so easily in the palm of my hand. She was just a few centimetres long and she lay so still on her side in the centre of my hand.
I held her a long time. I spoke to her. I wanted her to know how much we love her and that this did not change that, we always will. I wanted her to know that we would make sure she was remembered. I told her that she did not need to be afraid; that though, if I could, I would have let her stay cocooned in my womb for eternity, that now she had to leave she would still be safe. Jonathan came to see her. He said hello and goodbye to her and left us to talk some more. When I felt happy that she knew everything that I wanted her to, I said my goodbyes, stroked her tiny body and I placed her gently in a box, hugged by the teddy we had bought for her, and then placed them both within another box, ready to take their physical place in the earth.
She is in the little white box that you can see beneath her name card
My contractions actually worsened once she was out. It felt like my womb was now crying out too; mourning the loss of its most recent resident. It tore and twisted itself with grief. The hour that followed was just as surreal as the ones that had passed. Watching Jonathan dig the hole in our garden. Explaining to Harry once more that this is where his baby sister would sleep forever. Laying her box gently in the earth and watching it disappear from sight as the earth enveloped her; watching Jonathan plant the rose we had bought her on top of her resting place. Putting her slate into the freshly turned ground, her name etched before us. I felt like I was watching from afar as this played out. Surely it was not me who just cradled my dead baby in my palm and buried her in my garden.
But it was. That was me. That was my husband digging the hole, my son kissing the box his baby sister lay in, that was me, taking my baby from womb, to palm, to earth in the space of just a few hours. It is me who had to adjust to my new normal. And I am by no means the only one; this happens day in day out to families the world over, but that doesn’t make it hurt any less. That doesn’t make your experience or your baby any less valid. Everyone’s baby is their baby, their life is so important, their story is your story, to tell or keep as you see fit.
Olivia is our baby. She was our growing baby, our alive baby, our expected baby. She always will be our baby. The next days and weeks are going to be so difficult; we know that. I feel so empty right now, but I am giving myself the space to feel that. It is probably, if I think about it, the most natural expected feeling to have: I feel empty because I am empty. So much has happened in such a short space of time. Less than a week ago we were pregnant, planning the future for our baby and our family. Now our baby lies in the soil in our back garden and we have to find our way to cope with that. And we will. Nothing feels certain and everything takes time, though we know one thing for sure: We will never move on. She will not be left behind in this period of pain. We will move forward with her. She is part of our family and will be forever. She is Harry’s baby sister. She is a big sister to any children we may come to have. She is our baby, now and always.
She is Olivia.
***
This article was originally published on Rosie’s personal blog, Words for Olivia.
Rosie is 28 and lives in Oxford with her husband, son Harry and their dog, Nigel. She is mother to three children, Harry who is now three, Olivia who they sadly lost in March of this year and their third baby who she is busy growing. Rosie has a degree in English Literature and Creative Writing and has always enjoyed writing. Since losing Olivia, Rosie has found it incredibly therapeutic to write and talk about the reality of miscarriage in the hope of supporting other women who have experienced the same thing.

* Jasmine Collin from [Love Parenting UAE](https://www.loveparentinguae.com/), Nabta Health’s hypnotherapy partner, takes us through her guide to all things Hypnobirthing. * Learn how Hypnobirthing supports natural birth, reducing pain and creating an optimal environment during labour. * Nabta’s aim to empower women to reach their health goals as naturally as possible is very much in line with Jasmine’s approach and the benefits of hypnotherapy in labour. * Book Jasmine’s popular online Hypnobirthing course [here.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) You may have heard of hypnobirthing due to its increasing popularity with expecting parents and [celebrities such as Jessica Alba and Angelina Jolie.](https://www.madeformums.com/pregnancy/celebrity-mums-who-used-hypnotherapy-in-labour/) It’s even been suggested that royal family members, Kate Middleton and Meghan Markle used it to prepare for their births – but what exactly is it and why are so many women turning to Hypnobirthing? **What is Hypnobirthing?** Hypnobirthing is a childbirth preparation method taken as a set of weekly classes either in groups or privately, any time between 20-35 weeks of pregnancy. There are lots of styles of Hypnobirthing available today but they all originate from the Mongan Method, which is over 30 years old. There are also online Hypnobirthing classes available too There are a lot of [misconceptions as to what Hypnobirthing](https://www.loveparentinguae.com/single-post/2019/10/07/why-there-is-no-such-thing-as-a-hypnobirth) is and the type of person who chooses it. Many think it’s just for hippy types wanting a home or [water birth](https://nabtahealth.com/glossary/water-birth/) or those seemingly crazy women who want to do it without pain relief, but the truth is, all women can use it to have a calmer more positive birth experience, no matter what birth they choose or what path it takes. **What is the aim of Hypnobirthing?** One of the aims of Hypnobirthing is to support and increase the likelihood of physiological birth with the least amount of chemicals and interventions wherever possible. However if drugs or medical interventions are truly needed it enables the couple to remain calm and make informed evidence based decisions for themselves and their baby. #### **What are the benefits of natural physiological birth?** Studies have shown us that women and babies who have natural physiological births benefit from better health outcomes, adjustment to life outside the womb, emotional satisfaction with the birth experience and being able to cope well with the transition to motherhood. Read more about [physiological birth](http://www.birthtools.org/What-Is-Physiologic-Birth) and its benefits for families and society as a whole. Hypnobirthing promotes births that mirror nature as closely as possible so that babies and families can get off to the best start possible. #### **What if natural birth is not possible?** Unfortunately, natural physiological birth is not always possible in our current birth culture. There are a large number of influencing factors that we can’t control and birth can be quite unpredictable. So it’s important to acknowledge the wide range of birthing styles, combinations of drugs, interventions and different experiences that can happen, so we can fully prepare couples for all eventualities. The great news is that the knowledge and techniques learnt in Hypnobirthing classes are applicable in all situations and in all types of birth. In fact the tools can be even more useful in assisted births like C- sections, epidurals and inductions etc. because they keep the mother and baby calm during potentially more stressful events. #### **Real Hypnobirthing stories** Here are a few birth stories from parents who had all types of birthing experiences and how Hypnobirthing helped them through. [The induction for](https://babyandchild.ae/uae-birth-guide/article/1523/labour-was-more-powerful-and-beautiful-than-i-could-have-imagined) [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) one [The induction and low](https://www.jasminecollin.com/single-post/2019/05/06/Taylors-Birth---A-calm-positive-tale-of-thrombocytopenia-induction-low-fluid-and-more) [amniotic fluid](https://nabtahealth.com/glossary/amniotic-fluid/) one [The planned gentle C-section one](https://www.jasminecollin.com/single-post/2017/04/16/Hanis-Birth---A-Family-Centred-Cesarean) [The one with no progress](https://www.jasminecollin.com/single-post/2017/05/04/Charleys-Birth) [The big baby one](https://babyandchild.ae/uae-birth-guide/birth-stories/article/1372/how-hypnobirthing-helped-me-give-birth-to-my-5kg-baby-drug-free) [The unplanned C-section one](https://www.jasminecollin.com/single-post/2015/05/10/10-Healthy-Foods-That-Calm-DeStress) [The VBA2C (Vaginal Birth after 2 C sections) one](https://www.jasminecollin.com/single-post/2017/04/23/Marsels-Birth---A-VBA2C-Story) [The planned vaginal](https://www.jasminecollin.com/single-post/2017/08/13/Phoenix-Willows-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one [The unplanned vaginal](https://www.jasminecollin.com/single-post/2017/01/26/Georges-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one As you can read in the birth stories, Hypnobirthing can benefit mothers and babies in all situations – but it’s not just them that benefit. Let’s not forget the partners. These days’ partners are not just welcome in the delivery room; they are expected to support the mother during labour and birth. However, without adequate training this can throw them into an environment and situation that they are not adequately prepared for. In Hypnobirthing classes partners gain invaluable knowledge and skills that they can apply in the birthing room to ensure a positive birth experience for the mother, baby and themselves. And the benefits don’t just stop in the birthing room. Lots of couples continue to use the tools for relaxing the mind and body long after the birth is over. Read- [7 surprising reasons to do Hypnobirthing that have nothing to do with birth](http://www.loveparentinguae.com/single-post/2017/08/02/7-Surprising-Reasons-To-Do-Hypnobirthing-Classes-That-Have-Nothing-To-Do-With-Birth) #### **So how does Hypnobirthing work exactly?** **During pregnancy** It empowers couples with the knowledge and belief that women’s bodies are designed to grow and birth their babies and that childbirth is a natural physiological process. It promotes healthy nutrition and physical exercise in pregnancy as being key factors in having a safe and easier birth as well sharing top tips on how to get the baby into the optimal position for birthing. Like any big physical event such as running a marathon or climbing a mountain, it’s not just physical preparation that makes the difference. Yes, physical fitness plays a big part, but a positive mindset and being emotional fit is just as important, and this is where Hypnobirthing comes in. Hypnobirthing de-hypnotises couples from all the negative information and fear that they’ve been conditioned with all their lives and updates their mindset through guided visualisations, affirmations and fear release work, all while they are very deeply relaxed or ‘in hypnosis’. Being in a natural state of hypnosis, promotes deep relaxation and being open to suggestion, so during pregnancy we can give the mind set an upgrade by accessing the sub conscious mind and reprograming it with more positive beliefs, thoughts and feelings about birth. When pregnant woman are calm and feel fully supported, their babies, who are literally swimming in their emotions, also feel the benefits. During classes there is also a focus on pre birth family bonding and this helps couples to adjust to their new roles and embrace early parenthood more easily. #### **Hypnobirthing during labour & birth** When a woman goes into labour with less fear and more understanding of how her body works and what it’s doing at each stage she can accept it more easily and experience it in a more positive way. When she relaxes and welcomes the sensations, rather than fighting them, they can then become easier to manage. Practically speaking Hypnobirthing teaches couples how to maximize the normal physiological birth process by creating the optimal environment for birth. Humans are biologically programmed in the same way that all mammals are and our birth environment needs are very similar. All mammals birth more easily in safe, warm, dark, private, quiet and undisturbed settings where there is no rush and no feeling of being watched or observed. In this ideal setting the perfect and natural combination of birthing hormones can be released and labour can progress. If however there is any sense of a potential threat or disturbance, our fight or flight response can release hormones that will slow or even stop labour. Even a bright light or a cold room is enough to slow down labour. It’s not always possible to control the external environment though, for example when driving to the hospital or in a typical hospital room, where it’s normally bright, busy and rushed, with lots of observation, disturbances and possible fear triggers. Hypnobirthing skills are crucial in these less than optimal settings because they enable the mother to create a calm and resourceful internal mental state. Using her practiced breathing, visualisations, affirmations and hypnosis she can bring her body and mind into a deep state of relaxation as if she were in the ideal environment. The body cannot tell the difference between real and imagined, so she can use this mind-body hack to convince her body that it’s a safe space and a good time to be birthing her baby. The body then continues releasing the perfect cocktail of hormones for a quicker, easier and more natural birth. #### But what about the pain? A birthing mother automatically reduces pain by being calmer and less frightened of the birth, and in calm, safe settings the birthing body naturally produces [endorphins](https://nabtahealth.com/glossary/endorphins/), our own natural pain relief, to help us cope with the intense physical sensations. In addition, Hypnobirthing mums can use hypnosis to disrupt and change the way that their brain processes pain signals. They also learn mental coping strategies and physical comfort tools to deal with any discomfort that they feel. All these factors make it less likely that they will need pain relieving drugs or unnecessary interventions and they tend to have more straightforward and quicker labours. Of course if a woman is struggling then there is a selection of pain relieving drugs that the hospital can offer. The aim of Hypnobirthing however is to ensure the couple have a complete toolbox of skills and techniques that they can utilize before getting to that point, so that it can be delayed or avoided all together. But, no matter how a baby is born or whatever interventions or drugs are used, the most important elements for every birthing mother are that: * She feels calm, safe, and supported throughout. * She feels that she did her best and gave it all she had. * She feels treated with dignity and respect. * And she was able to make her own informed choices about her baby, body and birth, every step of the way. These are the key ingredients to a positive birth experience and what Hypnobirthing is all about. Surely every mother and her family deserves this birth experience…not just the hippies. \_\_\_\_\_ Jasmine Collin is a mother of two, a qualified Hypnotherapist, NLP Practitioner, Childbirth Educator and Doula who specialises in Hypnobirthing and Parenting Originally from the UK she is the longest running teacher in the UAE and has been teaching her award winning ‘Love Birthing’ classes since 2009. She is the co founder of Love Parenting UAE, winner of the 2018 Time Out Kids Award for ‘Special recognition for pre and post natal care’ and is dedicated to helping couples have calmer, more positive births so that they can ‘Love Birthing’ no matter what kind of birth they choose or what path birth takes. For more information contact: [\[email protected\]](/cdn-cgi/l/email-protection) You can book Jasmine’s popular online Hypnobirthing services on the [Nabta Women’s Health Shop.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) \_\_\_ Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) Get in [touch](/cdn-cgi/l/email-protection#acd5cdc0c0cdecc2cdced8cdc4c9cdc0d8c482cfc3c1) if you have any questions about this article or any aspect of women’s health. We’re here for you.

* [Stillbirth](https://nabtahealth.com/glossary/stillbirth/) is the loss of a baby in the womb after 24 weeks of pregnancy. * Every year there are an estimated 2.6 million stillbirths worldwide. * One third of stillbirths are unexplained. Around a quarter are caused by birth defects. Other risk factors include higher age, drug use and multiples. * Early warning signs of [stillbirth](https://nabtahealth.com/glossary/stillbirth/) include change the baby’s movements, bleeding, itching, fever and headaches. One [stillbirth](https://nabtahealth.com/glossary/stillbirth/) tragically occurs every 16 seconds according to the [World Health Organisation (WHO)](https://www.who.int/health-topics/stillbirth#tab=tab_3). The [National Institutes of Health (NIH)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/) acknowledges that there is no universally accepted definition for when a fetal death is called a [stillbirth](https://nabtahealth.com/glossary/stillbirth/). Rather than a [miscarriage](https://nabtahealth.com/glossary/miscarriage/) and the interpretation of gestational age differs by country. What causes [stillbirth](https://nabtahealth.com/glossary/stillbirth/)? ----------------------------------------------------------------------- [Around one third of stillbirths are unexplained](https://my.clevelandclinic.org/health/diseases/9685-stillbirth). According to the Centers for Disease Control and Prevention (CDC) [](https://www.cdc.gov/ncbddd/stillbirth/facts.html)[stillbirth](https://nabtahealth.com/glossary/stillbirth/) can happen to women of any age, background or ethnicity. The CDC goes on to say that the loss of a baby due to [stillbirth](https://nabtahealth.com/glossary/stillbirth/) occurs more commonly among: * Women with a higher maternal age; * Women who smoke or use recreational drugs during pregnancy; * Black women; * Women of a low [socioeconomic](https://nabtahealth.com/glossary/socioeconomic/) status; * Women who are pregnant with multiples (twins, triplets and quadruplets); and, * Women who have had a previous pregnancy loss. Blood-clotting disorders and chronic diseases (diabetes, heart disease, [lupus](https://nabtahealth.com/glossary/lupus/), obesity and thyroid disease) are also linked with increased risk of [stillbirth](https://nabtahealth.com/glossary/stillbirth/). As are complications with the [placenta](https://nabtahealth.com/glossary/placenta/) and [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/), maternal infections (group B streptococcus, [malaria](https://nabtahealth.com/glossary/malaria/), [HIV](https://nabtahealth.com/glossary/hiv/) and some STDs) and physical trauma. ##### Research says; [The Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/9685-stillbirth) says birth defects are the cause of around 25% of stillbirths. While Tommy’s says that [failure of the](https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/causes-stillbirth) [placenta](https://nabtahealth.com/glossary/placenta/) is the most common known reason for a baby to be stillborn. Half of all stillbirths linked to complications with the [placenta](https://nabtahealth.com/glossary/placenta/). The risk of the [placenta](https://nabtahealth.com/glossary/placenta/) calcifying increases when the baby reaches [full term](https://nabtahealth.com/glossary/full-term/). Over half of all placentas will experience some degree of calcification at [full term](https://nabtahealth.com/glossary/full-term/). Placental calcification preterm ranges wildly – from 3.8 to 23.7 percent – based on the risk factors listed above. What are the warning signs of [stillbirth](https://nabtahealth.com/glossary/stillbirth/)? ----------------------------------------------------------------------------------------- [Stillbirth](https://nabtahealth.com/glossary/stillbirth/) can occur without any obvious indicators but there are some signs to look for. If you experience any of the below symptoms during your pregnancy you should contact your medical team immediately. * **Change in baby’s movements**: Most women will start to feel the flutterings of their baby moving anywhere from 16 weeks onwards. By around 24 weeks the baby’s movements will be becoming more regular. [UK charity Tommy’s](https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/stillbirth-symptoms-and-risks) recommends that you learn to recognise your baby’s pattern of movements in the womb. Some women notice that their baby seems more active in the evenings. This is when they sit down and put their feet up or in response to the music beat during an exercise class. Others find their baby’s kicks increase when they eat spicy foods or drink a large glass of cold juice. The important point here is that if you notice any change in your baby’s movements – if the kicks suddenly seem less frequent or not as strong as usual – you should contact your doctor immediately. As this may be a sign that your baby is not getting enough oxygen or nutrients. * **Vaginal spotting or bleeding and cramping:** This could be the sign of placental abruption, [a serious condition in which the](https://www.marchofdimes.org/complications/placental-abruption.aspx) [placenta](https://nabtahealth.com/glossary/placenta/) separates from the wall of the [uterus](https://nabtahealth.com/glossary/uterus/) before birth. * **Vaginal discharge or fluid leaking from the [vagina](https://nabtahealth.com/glossary/vagina/)**: Discharge could be linked with an intrauterine infection or infection in the womb. Leaking fluid could be your waters breaking early. * **Feeling something in your [vagina](https://nabtahealth.com/glossary/vagina/) during pregnancy:** This might be the sign of an [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/) prolapse which would mean your baby isn’t getting enough oxygen. * **Itching:** Severe itching on your palms and soles of your feet may be a sign of Intrahepatic Cholestasis of Pregnancy (IHP). It is a pregnancy-related liver condition that can [lead](https://nabtahealth.com/glossary/lead/) to [stillbirth](https://nabtahealth.com/glossary/stillbirth/). Also called obstetric cholestasis you should report any itching to your physician. * **Fever:** Some infections during pregnancy can be dangerous for an unborn baby. * **Headaches, blurred vision or swelling:** These can be [symptoms of](https://nabtahealth.com/articles/what-is-preeclampsia/) [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) which can [lead](https://nabtahealth.com/glossary/lead/) to loss of pregnancy in the womb. Your medical team will monitor your symptoms including carrying out an ultrasound to check your baby and using a [doppler ultrasound](https://nabtahealth.com/glossary/doppler-ultrasound/) to measure the fetal heart rate. It is important that you attend all your routine antenatal tests and scans and report any concerns or unusual symptoms you have. However slight you feel they may be, as soon as you notice them. Getting the support you need after [stillbirth](https://nabtahealth.com/glossary/stillbirth/) --------------------------------------------------------------------------------------------- Losing a baby at any stage is devastating and it is important that you, your partner and family get the physical and emotional support you need. Your [healthcare team](https://nabtahealth.com/team/) will be able to advise on the local support networks and dedicated charities there to support you. — Nabta is reshaping [women’s healthcare](https://nabtahealth.com/). We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your symptoms and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) Get in [touch](/cdn-cgi/l/email-protection#740d15181815341a151600151c111518001c5a171b19) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources** “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” The Cleveland Clinic https://my.clevelandclinic.org/health/diseases/9685-[stillbirth](https://nabtahealth.com/glossary/stillbirth/) “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” WHO, [https://www.who.int/health-topics/](https://www.who.int/health-topics/stillbirth#tab=tab_3)[stillbirth](https://nabtahealth.com/glossary/stillbirth/)#tab=tab\_3 Tavares da Silva, F, “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/): Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data” Dec 2016, Vaccine, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/) “What is [Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” CDC https://www.cdc.gov/ncbddd/[stillbirth](https://nabtahealth.com/glossary/stillbirth/)/facts.html “Causes of [Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” Tommy’s, https://www.tommys.org/baby-loss-support/[stillbirth](https://nabtahealth.com/glossary/stillbirth/)\-information-and-support/causes-[stillbirth](https://nabtahealth.com/glossary/stillbirth/)

Polycystic ovary syndrome ([PCOS](https://nabtahealth.com/glossary/pcos/)) is a common hormonal disorder that can affect a woman’s ability to get pregnant. While having [PCOS](https://nabtahealth.com/glossary/pcos/) does not necessarily increase a woman’s chance of [miscarriage](https://nabtahealth.com/glossary/miscarriage/), it can make it more difficult for her to conceive and can also increase her risk of other pregnancy complications. [PCOS](https://nabtahealth.com/glossary/pcos/) is a condition in which the [ovaries](https://nabtahealth.com/glossary/ovaries/) produce an excess of male hormones, which can interfere with the development of eggs and make it more difficult for the eggs to be released from the [ovaries](https://nabtahealth.com/glossary/ovaries/). This can make it more difficult for a woman with [PCOS](https://nabtahealth.com/glossary/pcos/) to get pregnant. * There is a known link between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/), but there is not enough data on this topic. * There is no solid evidence that any drugs can mitigate the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/). * Choosing a healthy lifestyle is one of the key ways you can increase your chances of staying pregnant and preventing [miscarriage](https://nabtahealth.com/glossary/miscarriage/). A link between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/) was first described in the late 1980s and yet, despite this, in the past 30 years very little progress has been made. We are still not sure why women with [PCOS](https://nabtahealth.com/glossary/pcos/) are at greater risk of miscarrying and, perhaps more importantly for those affected, we are no closer to finding a solution. It almost goes without saying that this is an area of research that desperately needs more attention and resources. Here we explore the limited data available, discuss why the need for answers is getting greater, and suggest what you can do to maximise your chances of falling pregnant and staying pregnant. You can track your pregnancy free of charge [using the Nabta App](https://nabtahealth.com/our-platform/nabta-app/). **What does the data suggest about [PCOS](https://nabtahealth.com/glossary/pcos/) and [Miscarriage](https://nabtahealth.com/glossary/miscarriage/)?** ----------------------------------------------------------------------------------------------------------------------------------------------------- Women with [PCOS](https://nabtahealth.com/glossary/pcos/) often struggle to conceive; in fact, the condition is considered to be one of the [leading causes of](https://nabtahealth.com/causes-of-female-infertility-failure-to-ovulate/) [infertility](https://nabtahealth.com/glossary/infertility/) in females. The problem is that once pregnant, those women with [PCOS](https://nabtahealth.com/glossary/pcos/) are also at increased risk of going through the trauma of one, or even multiple, [miscarriages](https://nabtahealth.com/miscarriage-101/). Women with [PCOS](https://nabtahealth.com/glossary/pcos/) are three times more likely to miscarry than those without [PCOS](https://nabtahealth.com/glossary/pcos/). There is some evidence that women who suffer recurrent miscarriages are more likely to have [polycystic](https://nabtahealth.com/do-polycystic-ovaries-equal-pcos/) [ovaries](https://nabtahealth.com/glossary/ovaries/), but no proof that this abnormal ovarian morphology is causing pregnancy loss. There is also very little data to support the idea that increased levels of luteinising hormone or [testosterone](https://nabtahealth.com/glossary/testosterone/) are implicated in [miscarriage](https://nabtahealth.com/glossary/miscarriage/). One of the biggest issues with the work that has been completed to date is that many of the studies rely on retrospective evidence. The accuracy and reproducibility of the results is dependent on participant recollection. As a result, many of the large scale reviews have deemed the evidence that is currently available to be of low quality and inconclusive. Also, the variation in the criteria used to define [PCOS](https://nabtahealth.com/glossary/pcos/) before the Rotterdam criteria became the [gold](https://nabtahealth.com/glossary/gold/) standard in 2003, led to some inconsistencies in the association between [PCOS](https://nabtahealth.com/glossary/pcos/) and miscarriages. **Why does the association between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/) urgently require further work?** ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- [](https://nabtahealth.com/what-is-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) is a medical condition that is not going to disappear any time soon. In fact, the percentage of women affected by it is likely to increase over the coming years. [PCOS](https://nabtahealth.com/glossary/pcos/) is [strongly associated with obesity and](https://nabtahealth.com/treating-the-associated-symptoms-of-pcos/) [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/); and, whilst these two conditions are increasing in prevalence across the developed world, an unfortunate consequence of this will be that more women will find themselves facing the realities of a [](https://nabtahealth.com/problems-with-traditional-diagnosis-of-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) diagnosis. We know that women with [PCOS](https://nabtahealth.com/glossary/pcos/) who do conceive are at risk of further pregnancy complications, including [](https://nabtahealth.com/gestational-diabetes-8-things-you-should-know/)[gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/), [](https://nabtahealth.com/what-is-preeclampsia/)[preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) and premature delivery. This is financially costly, placing an increasing burden on healthcare systems across the world; but it is also emotionally draining for those couples who have to go through it. Experiencing a [miscarriage](https://nabtahealth.com/glossary/miscarriage/) can be a devastating experience. There can never be a right or wrong way of coping with and managing your loss. However, for many women, closure, or acceptance, is possible once they understand why something has happened. We need to improve our knowledge on [](https://nabtahealth.com/pcos-and-pregnancy/)[PCOS](https://nabtahealth.com/glossary/pcos/) and pregnancy; we need to better understand why [PCOS](https://nabtahealth.com/glossary/pcos/) increases the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/); and, perhaps above all, we need to give those women who have experienced a loss, answers. **What can you do to manage your risk of miscarrying and increase your chances of a healthy pregnancy?** -------------------------------------------------------------------------------------------------------- As already discussed, there is significant work to be done to support the risk of [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/). Some reports have suggested that [ovulation](https://nabtahealth.com/glossary/ovulation/) induction agents, such as clomiphene citrate and [metformin](https://nabtahealth.com/i-have-pcos-should-i-take-metformin/), might improve live birth rates. In fact, metformin is not strictly an [ovulation](https://nabtahealth.com/glossary/ovulation/) inducer, it is used to treat [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/), and has, therefore, been used ‘off-label’ to manage some of the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/). There is limited evidence that it improves [ovulation](https://nabtahealth.com/glossary/ovulation/) rates. There is no solid evidence that either of these drugs reduce the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/) and the data across different studies remains conflicting. Whilst this may all be sounding a little depressing, there is one key thing that should be remembered; [many of the symptoms of](https://nabtahealth.com/is-it-possible-to-reverse-pcos/) [PCOS](https://nabtahealth.com/glossary/pcos/) can be alleviated by making healthy lifestyle decisions. Losing weight, exercising more, making considered choices with regards to your [diet](https://nabtahealth.com/eating-to-conceive/), these are all things that can help to improve menstrual cycle regularity. This in turn, increases your chances of getting, and staying, pregnant. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#354c54595954755b545741545d505459415d1b565a58) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Cocksedge Karen, et al., “How common is polycystic ovary syndrome in recurrent [miscarriage](https://nabtahealth.com/glossary/miscarriage/)?” _Reproductive Biomedicine Online_, 2009 Oct;19(4):572-6. doi: 10.1016/j.rbmo.2009.06.003. PMID: 19909600. * “Does [PCOS](https://nabtahealth.com/glossary/pcos/) Affect Pregnancy?” _Eunice Kennedy Shriver National Institute of Child Health and Human Development_, U.S. Department of Health and Human Services, [www.nichd.nih.gov/health/topics/](http://www.nichd.nih.gov/health/topics/pcos/more_information/FAQs/pregnancy)[pcos](https://nabtahealth.com/glossary/pcos/)/more\_information/FAQs/pregnancy. * Kaur, R and Gupta, K. “Endocrine Dysfunction and Recurrent Spontaneous Abortion: An Overview.” _International Journal of Applied and Basic Medical Research_, vol. 6, no. 2, 2016, pp. 79–83., doi:10.4103/2229-516x.179024. * Legro, Richard S., et al. “Clomiphene, Metformin, or Both for [Infertility](https://nabtahealth.com/glossary/infertility/) in the Polycystic Ovary Syndrome.” _New England Journal of Medicine_, vol. 356, no. 6, 8 Feb. 2007, pp. 551–566., doi:10.1056/nejmoa063971. * Mills, Ginevra, et al. “Associations between Polycystic Ovary Syndrome and Adverse Obstetric and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Outcomes: a Population Study of 9.1 Million Births.” _Human Reproduction_, vol. 35, no. 8, 9 July 2020, pp. 1914–1921., doi:10.1093/humrep/deaa144. * Rai, Raj, et al. “Polycystic [Ovaries](https://nabtahealth.com/glossary/ovaries/) and Recurrent [Miscarriage](https://nabtahealth.com/glossary/miscarriage/)—a Reappraisal.” _Human Reproduction_, vol. 15, no. 3, 1 Mar. 2000, pp. 612–615., doi:10.1093/humrep/15.3.612. * Sagle, M., et al. “Recurrent Early [Miscarriage](https://nabtahealth.com/glossary/miscarriage/) and Polycystic [Ovaries](https://nabtahealth.com/glossary/ovaries/).” _Bmj_, vol. 297, no. 6655, 22 Oct. 1988, pp. 1027–1028., doi:10.1136/bmj.297.6655.1027. * Sharpe, Abigail, et al. “Metformin for [Ovulation](https://nabtahealth.com/glossary/ovulation/) Induction (Excluding Gonadotrophins) in Women with Polycystic Ovary Syndrome.” _Cochrane Database of Systematic Reviews_, 17 Dec. 2019, doi:10.1002/14651858.cd013505.