Email To A Suffering Woman

I got an email from someone who just suffered a miscarriage after her one and only pregnancy after trying to conceive for five years. She asked for my advice on how to move through it, since she is in so much pain. I am posting my response to her here, in case it contains advice that helps someone else who is hurting.

"Dear H,

I am so sorry for your loss. I have been through this three times, and it is excruciatingly painful. Since you asked for advice about how I survived, here ya go. Take what you like and ignore the rest:

1. You WILL get through this. One day at a time, sometimes one hour at a time. You are grieving, and that is ok. Take it easy on yourself, and stay out of self-judgement. Try to take good care of yourself, the best you can: good nutrition, getting to bed at a reasonable hour, perhaps tea with a trusted buddy you can cry to. If you are spiritual and part of a faith community, connecting with that might help, though anger at a Higher Power is totally normal, too. And, dare I say it, exercise helps. Getting my ass to the gym post-miscarriage was one of the best things for me mentally and physically.

2. The biggest challenge for me was that my husband and I grieved the loss of our babies differently. It was very hard to be with him because seeing his face (the father of my kids!) really heightened my grief. He was the only other person on the planet suffering the way I was, and sometimes being with that was too much. Instead of pulling away, I had to consciously move closer to him. Not easy, but worth it. We had to figure out a way for each of us to grieve our own ways; me by wallowing in it for a while, him by losing himself in work. One isn't right or wrong, better or worse. Just different, and we had to allow space for each others grieving styles.

3. This is very, very hard to hear, and I don't say it lightly. Nor would I say this to you without having lived through this: as much as I understand your sentiment that this feels worse than just not conceiving, it is actually a very hopeful sign for your ability to conceive in the future. Several reproductive endocrinologists have told me, "It's a sign that something is working." Cold comfort for where you sit now, I know.

Please know I am sending healing thoughts your way and I am here if you need something. This hurts like hell, and yet you will rebound, I promise. Winston Churchill wisely said, 'If you're going through hell, keep going.' Take it easy.

Blessings,
Sarah"

You Gave Me A Mountain

"This time, Lord, You gave me a mountain, a mountain you know I might never climb. It isn't just a hill any longer -- You gave me a mountain this time."  - "You Gave Me A Mountain," lyrics by Marty Robbins, sung by Elvis Presley

"There is sorrow beyond all grief which leads to joy and fragility, out of whose depths emerges strength." - Rashini

I have had a lot of reproductive disappointments lately. It feels unbearable to write about them, but when I realized I haven't posted anything in almost a month, I knew why: this is what is going on, and I'm not in the mood to talk about it. Yet, this topic feels like a blockage, and until I write about it, I can't write about anything else. This sucks unlike anything else I've ever been through. I don't want to make it sound like I've been on death marches, sex trafficked, or anything else truly horrific, but for a privileged white girl, I have had my share of genuine tragedy and heartbreak, and infertility (IF) exceeds it all. Perhaps it's because IF touches on such deep, personal longing: religiously and culturally, most people have been inculcated with a deep desire to have children. Hell, if you are from a Judeo-Christian background, it's the first frigging commandment. If I were inclined, I could write a separate post about what IF has done to my spirituality and relationship with God. It aint pretty. Add to that the intense biological drive to propagate, and you have a potent mix for being really fucked up if things aren't working in the reproduction department.

When I had my miscarriages, I was shocked at the insensitivity of other infertile women who said, "Well, at least you can get pregnant.  I haven't been able to do that." I still stand by the insensitivity of expressing that comment to someone who has lost three babies, but from where I sit now, I agree. For unknown reasons, I have gone from the camp of the super-fertile to the "...and to think, I wasted all that birth control!" camp. When you can get pregnant, there is still hope that this pregnancy will turn out ok. Now, I understand the frustration of getting yet another period when you don't want one. This is worse.

That leads me to another point: I have had to eat some real humble pie. My IF journey has led me to feelings and behaviors that I thought I was above, and I find myself experiencing many of the things I judged other infertile women for. For example, I used to think it was strange when someone told me she couldn't be at synagogue with all the kids. Now, I totally get it. Not wanting to be around pregnant women? Check! Not wanting to be around babies? Double check! Feeling like a playground or Facebook is an emotional minefield (especially around the anniversary of Roe v. Wade)? Check! I actually hid a new parent's Facebook feed recently because all she posts about is her new baby (kudos and thanks to my other friends who are new parents who do a great job balancing info about parenthood with other things! I love you!) In a strange way, I feel like the Universe is giving me a dose of all the things I used to be judgmental of. I assure you, I'm not anymore. I have also learned that the IF drugs, with the intense bloating they cause, make you look pregnant, so I shouldn't assume anyone is.

Maintaining perspective on this problem of IF is not for the faint of heart. It is easy to let it consume you. One of the common ways to try to balance the pain is to look at what is going right in my life, which, thank God, is a lot! Most importantly, I get to wake up every day next to my best friend and partner, whom I'm still madly in love with. I think marriages like ours are rare. My life is full of blessings! Yet, I have to be careful with this tack, because I also use it as a way to negate my feelings of intense sadness. Yes, life is beautiful, but it still feels for both of us like our family is incomplete. For these reasons, it feels like this method of focusing on the positive isn't an authentic or truly useful way in and of itself for me to work through this problem.

I did have some relief this morning when I did a guided tonglen practice led by my meditation teacher, Tara Brach. This is a powerful practice that helps us connect with the suffering of ourselves and others in a meaningful, compassionate way. I found it very calming to view IF as a wave held in the greater awareness of my life as an ocean. To paraphrase Tara, when you're aware you're the ocean, you're not as afraid of the waves. I also like the tonglen practice because an integral part of it is focusing on the suffering of others, and in doing so, it feels like offering a prayer on their behalf.

Ok. I have been sitting on this post for a week, and can't think of anything else I'm willing to commit to the Internet, so here it is for now.

True Refuges

"Your lost Joseph will return to Canaan, do not grieve
This house of sorrows will become a garden, do not grieve

Oh grieving heart, you will mend do not despair
This frenzied mind will return to calm, do not grieve

When the spring of life sets again in the meadows
A crown of flowers you will bear, singing bird, do not grieve

If these turning epochs do not move with our will today
The spheres of time are not constant, do not grieve

Don’t lose hope, for awareness cannot perceive the concealed
Behind the curtains hidden scenes play, do not grieve."  -- Hafez, "The Lost Joseph" (full poem here)


"I'm here without you baby, but you're still on my lonely mind
I think about you baby, and I dream about you all the time." - Three Doors Down, "Here Without You"



I don't know how much more I have to say about the horrors of miscarriage, except to say that they seem to get exponentially worse. With one miscarriage, it's like, "Well, this sucks, but 25 percent of all pregnancies end this way, so we'll grieve, hope and proceed forward." With two in a row, it's like, "Uh-oh, I hope this doesn't indicate a trend. Just bad luck." With three in a row, you become a "serial miscarrier" and the stakes change. Our most recent miscarriage is like a gigantic hole in my heart. It feels like more of a profound loss, in part because it's our third blow of this kind in a year, and I think in part because we felt some relief that we heard and saw our baby's heart beat. Even though I still worried, that gave me some hope that things could be ok. Nevertheless, it turns out our daughter had an extra thirteenth chromosome, which is incompatible with life. Knowing this was a little girl, and not an anonymous "it" makes this even more personal and painful.

One thing this year-long curriculum in grief has taught me is how much of a precious gift it would be for all of us to give each other the gift of mindful listening. In our culture, "help" has become synonymous with "fix": people see David and me hurting and want to relieve us of our suffering, so they make offers of "help" from the reasonable to the sublime to the ridiculous. The people who have been the greatest help to me have been those who say, "This sucks. You are in the middle of something awful and unfair, and I am so sorry for you." Bless you. One of the reasons that you don't say anything when you enter a Jewish house of mourning is that there is nothing to say. Loss is ineffable.

All of my old complaints about the hurtful things people say and do in their attempts to "help" still stand, though I have some new complaints too. The primary one is women offering me advice for their fertility problems, which are not our fertility problems. There are many stages where reproduction can fail, and I find myself exasperated with advice (again, well-meant) from people who have a totally different problem we do. They don't realize that their suggestions are equivalent to suggesting Lupron, a prostate cancer drug, for a breast cancer patient. But hey, they're both cancer! To all you progesterone pushers: all the hormones in the world would not have negated an extra chromosome, but that will be a later post. I am not immune to this desire to "help"; God help you if you ask me about Lyme Disease, because you will get an hour lecture full of strong opinions! Then again, in my defense, Lyme and co-infections have one cause, though many presentations of the diseases. Infertility is quite a bit more complex since it can have different causes, many causes, or be completely idiopathic.

I am all about care right now for David and me. Frankly, right now, other people's needs come significantly below ours. In trying to determine how to best care for myself, I keep asking myself, "What and who are true refuges for me?" This has guided how I am spending my time and who I am spending it with. No refuge for Sarah, no Sarah. This means a lot of calls to me are not being returned, and that's totally as it should be.

To my great surprise, one of my most helpful refuges has been meditation. It is surprising because my meditation cushion is kinda the loudest place in the house nowadays. You wake up to what is when you meditate, and if what you're waking up to sucks, it really hurts! I listened to a dharma talk today by Sylvia Boorstein titled "May I Meet This Moment Fully, May I Meet It As A Friend." I've been repeating that throughout the day. Some days, like this morning, I was able to compassionately touch my grief in my meditation; other days, it is too intense, and I return to the traditional metta (loving-kindness/blessing) practice.

Loving, compassionate, close friends and family members have also been a true refuge, as have both of my spiritual communities: my Jewish one and my meditation one. I found out last Wednesday that our baby died, yet I couldn't imagine being anywhere other than with my sangha (meditation community). I was hugged by so many people, and got kind follow-up emails from people sending me metta and checking on me.

Little Kacy, our dog, is a true refuge, as always. And on a different wavelength, good TV, in moderation, provides much-needed distraction. What are your true refuges?

Wasted Time?

"Is it all just wasted time? Can you look at yourself when you think of what you left behind?" - Skid Row, "Wasted Time"

Unsurprisingly, I think a lot about miscarriage. I have been pregnant seven out of the last 12 months of the year. Not the fun, rewarding, feel-good parts of pregnancy I imagine, but the nausea, exhaustion, want-to-gnaw-my-arm-off-from-hunger first trimester. Although we saw Eddie the embryo's heartbeat -- a milestone in our personal pregnancy history --  we have a long way to go. I think I'll be able to exhale a little if I make it past the first trimester, but I know families who have lost babies literally in every month of a pregnancy, and through stillbirth, so I have no illusion that you're ever really out of the woods.

I think almost every day about the possibility of miscarriage. The other day I was thinking, "What would be the worst part about miscarrying?" I was a little embarrassed to note my answer to myself: "the wasted time." The nausea, hunger, exhaustion, and lack of libido would be more tolerable if I was sure they would pass, that they would just be way-stations on the way to a healthy kid. As they are, they have been the sum total of my pregnancy experience. I don't mean to sound ungrateful, because I'm thrilled I am pregnant! But I feel like hell, and again, I've spent more than half of the past year in that state. Staying in my first trimester feels like spinning my wheels. It seems fair to add that when I feel this bad, I don't do a lot of socializing, so I feel like I'm missing some opportunities on that front by spending all this time in first-trimester land.

God forbid, if I lost this pregnancy, I would, of course, be devastated beyond feeling like I wasted time. I passed some kids drawing with sidewalk chalk this evening and my heart almost exploded from wanting. But I know I could get through the loss, and I know I could get pregnant again, since that doesn't seem to be a problem. I am just sick of feeling stuck, of feeling like I'm wasting time. I want to move forward. Intellectually, I know that whatever happens will be a kind of moving forward, but that is a solution for the mind, and again, this is a matter for the heart.

Shared Sorrow, Shared Joy

"You have the pain, the sorrow, the fear within yourself; don't keep it for you alone. Allow the sangha, allow the community to embrace it for you. Allow the collective energy to help you to embrace it, because alone, you are not strong enough to embrace your pain, your sorrow ... If we allow the community to embrace us, then we will not sink into the ocean of suffering." -- Thich Nhat Hanh

May 17 was one of the most nerve-wracking days of my life. I was heading in for my third prenatal sonogram ever; the first two revealed that our embryos didn't take off, the cells never differentiating enough to create organs. I was expecting the worst at this one. My anxiety was palpable; I even sobbed in a public restroom the night before. I just needed an outlet for that anxiety to leave my body, and that night, it was in tears. I was looking for a way to process this anxiety, and one of my mindfulness teachers gave me a good suggestion: to tap into collective suffering as a way of making the container for my own suffering bigger. I think this is akin to Tara Brach's oft-quoted metaphor that if you are in touch with the whole ocean, you are less afraid of the waves.

So, I stopped looking at Wednesday's appointment as "my" ultrasound, and started thinking of all the women who have been on that same table I was going to be lying on. I broadened the thought to all the women having fertility issues everywhere, and more broadly, every expectant mom praying that everything would be ok with her sonogram. The exercise didn't stop there: I was able to relate my worry about the sonogram to all the suffering of the world, and I thought in particular about a dear friend of mine right now who is very sick. I can't explain why this helped ease my anxiety, but it did. It took me out of myself, and made me a part of something bigger, which, of course, I am.

Before David and I got out of the car to head up to the clinic, we prayed together, asking God for a favorable outcome to the sonogram, or the strength to get through this together if it was not a favorable outcome. I don't think anyone was more surprised than I was to hear our doctor say, "So, there's the baby, and you can see it's heart beating." Hearing that heart beat* was magical, though I could barely hear it through my tears of joy (and shock!)

The concept of sharing sorrow doesn't just exist in the narrow way I describe it above. It has helped me more than once to share my sorrows with all of the communities I'm blessed to be a part of. One of the starkest contrasts David and I noticed was the aftermath of my father's death vs. our first miscarriage a few weeks later. After my dad's death, there were about 70 people here a day to sit shiva with me. I found their presence comforting. We largely faced the miscarriage silent and alone, except for the few friends we notified. Several of them came to hang out and talk. Suffering of this magnitude is too big to be handled alone, and I am often saddened by the many women who tell me they have had serious fertility problems, miscarriages, and ectopic pregnancies and told no one other than their doctors. I am including women whom I know who are extremely close to their mothers, yet never tell their moms about these events. This kind of extreme secrecy only harms, in my opinion, never heals.

The concept of shared joy is as powerful as shared sorrow. In my immediate circumstance, experiencing my wider social circle's joy at our pregnancy is infectious and exciting. In a broader context, this is a skill I have had to work to cultivate over the past few years. My disability from Lyme Disease has meant the end to many professional and social opportunities that I used to enjoy. When you encounter that, your choice is to withdraw and become closed off and contracted, or to learn to cultivate joy from others' happiness. At times, it was very hard to hold this joy as most of my friends expanded their families as I was struggling with first having to delay childbearing because of my infections, and later, my inability to stay pregnant. Nevertheless, I have always found this goal worth pursuing to the best of my ability.

=======
* Seeing the six week-old on this sonogram was powerful for me in another context: seeing and hearing that little heart beating brought me back to when I used to volunteer for Planned Parenthood in what seems like another lifetime. They drilled into us in the clinic where I volunteered that what was being aborted was "just tissue." Seeing the heartbeat in my sonogram reinforced my unease with abortion, and also made me understand why pro-choice advocates are so upset by Christian pregnancy counseling centers using early ultrasound to influence women's decisions about their pregnancies. It also occurred to me, seeing that beating heart, that it was "just tissue" -- the same way my heart, my hands, and my brain are also "just tissue."

Real But Not True

"They say it's never too late
To stop being afraid
And there is no one else here
So why should I wait?
And in the blink of an eye the past begins to fade

So have you ever been caught in a sea of despair?
And your moment of truth
Is the day that you say 'I'm not scared'

Put your hands in the air
If you hear me out there
I've been looking for you day and night
Shine a light in the dark
Let me see where you are
'Cause I'm not gonna leave you behind

If I told you that you're not alone
And I show you this is where you belong
Put your hands in the air
One more time..." -- "Unity" by Shinedown


I feel like I've been selling our baby short. Every time someone congratulates me on our pregnancy, I have to somehow negate it with, "Yeah, but, this is my third pregnancy in a year, so we'll see..." I realize I'm saying this for me, not them, but it has been bothering me: I feel like I've been selling our baby short. Again, we encounter the brain's weak attempt to protect me from something that isn't happening. Thank you, brain.

I heard Tsoknyi Rinpoche speak recently (you can listen to his inspiring, funny talk here), and am currently reading his book "Open Heart, Open Mind." One of the most powerful concepts he presents is "real but not true." That is, something can be very real for you, but not actually factually correct. In my case, my fear of losing this pregnancy is very real, and not to be minimized. At the same time, for today, it is not true that I am losing the baby I am carrying. I am very tempted to write "real but not true" on an index card and keep it in my purse. My very real feelings and stories about pregnancy loss are based on my history, my brain's attempt to make sense of it, and my physical body's -- and subtle body's, i.e. energetic field, emotions, etc. -- interpretations of these experiences. For today, which is all any of us has, it is not true that I'm losing this pregnancy. Therefore, it's not fair for me to sell our little one short by qualifying news of our pregnancy with reports of my miscarriages.

I was driving home yesterday from a half-day mindfulness retreat for my Mindfulness-Based Stress Reduction class I'm enrolled in. I normally don't listen to the radio when re-entering the real world after a retreat, but I was so exhausted, I feared falling asleep if I drove home in silence. So, I put on Shinedown's amazing new album, "Amaryllis." Their song "Unity," quoted above, is powerful even if you are not moody and pregnant, and I highly recommend a listen.  However, since I am especially sensitive and emotional right now, it really hit me. Tears started streaming down my face, to the point I considered pulling over. Particularly, the idea that "I'm not gonna leave you behind," and the idea that this baby is NOT alone, and that if God wills it, she or he belongs with David and me -- all concepts related clearly in "Unity." I want to set the intention of encouraging him or her, not prematurely giving up became of my fears based on the past. Grow little one, grow and thrive!

Words That Harm, Words That Heal

"Words are, in my not so humble opinion, our most inexhaustible source of magic, capable of both inflicting injury and remedying it." -- Albus Dumbledore to Harry Potter in film "Harry Potter and the Deathly Hallows Part II"

"Too much time on my hands, I got you on my mind
Can't ease this pain, so easily
When you can't find the words to say, it's hard to make it through another day
And it makes me want to cry, and throw my hands up in the sky." -- Iron Maiden, "Wasted Years"

I am so grateful to all the friends, family and acquaintances who are reaching out in many ways to express their sympathy to David and me about the recent loss of our unborn child. Most people say something along the lines of, "I don't even know what to say to you." That is unsurprising, because there is very little to say other than, "I'm sorry," which feels inadequate to most people saying it, even though it isn't to me when I'm hearing it. In fact, I would argue that when you veer much beyond that, you risk stepping over a line. I am obviously very public about this, which opens me up to all kinds of comments from well-meaning people. But I've had to reconcile enough painful "condolences" these last two weeks that I want to write a specific post about some do's and don'ts to comfort women who have miscarried. Obviously, every couple is different and every loss is different, so I'm sure there are people who would not be offended by what offends me, or who might not be comforted by what comforts me. But, I'm pretty reasonable, and I think I can provide a place to start. A friend of mine asked me to pen this.

Don'ts

1. Here be dragons! There is one primary thing to avoid when talking to a couple or woman who has lost her baby: please do not say anything along the lines of, "There was something wrong with the baby. That's why this happened." Nothing is less relevant and more hurtful at this time. Grief is a duty of the heart, and this comment is rational, a response of the mind. Yet, if I had a dollar for every time someone said it to me lately, I could treat a dozen friends to Venti-size expensive coffee drinks. Let me qualify this by saying that most people who dole out the "something was wrong with the baby" line are well-meaning people who are trying to help. Quite a few of them are female friends of mine who have miscarried, and this line of reasoning helped them cope with their pregnancy losses. Yet, it cut me like a knife when I heard it, and was only made worse by the people who embellished it with, "Better this than you have a child with an illness or a special-needs child." This is offensive on so many levels, I can't even go here.

We are decently bright people, and we understand the science quite well; biology was my minor and remains an interest, and I was a health writer. Furthermore, as common as miscarriage is (very), it is actually not well-understood and varies case-by-case. An acquaintance of mine related this "something wrong..." line in the name of her husband, a paramedic. When I whined to a friend of mine -- a very advanced health-care professional with a 23-year career in obstetrics -- about this she gave the deliciously snarky reply: "Wow. I'm so impressed that her husband the paramedic has figured out what the best researchers and physicians in my field continue to study and struggle with." In other words, it's complicated. In fact, a reproductive endocrinologist has since explained to us that there are five main categories of miscarriage, and there being a problem with the baby itself is just one of those five. That leaves four other possibilities.

Even if you have miscarried and even if it comforted you to believe that the pregnancy terminated because of a specific problem, it is enough of a potential bombshell that it's probably best to avoid saying it to someone else.

2. No Medical Advice, Please: Pirkei Avos (Ethics of the Fathers) states, "Who is wise? He who learns from all people" (4:1). However, there are limits to this, and if there is one thing I excel at, it's taking care of my wellbeing. My journey with Lyme Disease and fibromyalgia has ensured that I have to be a fierce advocate for myself; I have spent years learning how to make the health care system work for me and my family, and I don't accept any half-assed medical care. So, I don't want to sound haughty, but my experience is that most people who don't have an M.D., NP, or PA credential after their initials don't have much to teach me about medicine. I get my referrals from top-rate doctors who know my health history and my personality well. I had a cousin recommend I get tested for a clotting disorder that runs in the family, which I really appreciated, and still many others say, "Let me know if you need medical referrals." I appreciate all that, but not much more specific advice unless you have had the same problem that I have and have specific information that could help me. I acknowledge that until now, I have had no experience with reproductive problems, so what I do value is other women's and couples' experiences who have been on this journey. However, if one more person tells me that acupuncture would prevent a miscarriage, I'll hurl on their shoes, I promise.



Seriously, I'm thrilled you're pregnant: Don't be afraid to tell me you're expecting. Just tell me in private if we're close friends. I'm genuinely happy for my friends who are expecting, and perhaps selfishly, I never want to become someone who isn't happy for people who are pregnant. It's just important to me. I think I've done a good job of holding my own disappointments in one hand, and the joy of my friends expecting children in the other.

Etc.: Another thing that has been hard for me to handle are any kinds of statements about my personal faith through the tragedy of a miscarriage. As I mentioned in an earlier post, I bristled at someone's comments to me along those lines. I think it's probably best not to make any presumptions on this topic. The other thing that annoyed me is people who ignored this because of their own awkwardness; it's a big deal to us, and no, we don't expect you to fix it, or even really comfort us. So, with all that said, what does help?

Do's
1. Gifting Yourself: The number one helpful thing that other people did for me in the aftermath of the miscarriage was spend time with me. I had friends come over and hang out with me, hold me while I cried, and walk the dog with me. Sometimes all three! These visits lasted from 45 minutes to three hours, and they really helped. Other people checked up on me with frequent phone calls, text messages, e-mails, and Facebook messages. That also made me feel cared about. My religious community kindly cooked meals for our Sabbath, so David and I wouldn't have to worry about feeding ourselves; that was hugely helpful, and made us feel really cared about. Other people sent cards, which also felt good. Again, people just reaching out to say, "I'm so sorry," is really what mattered to us.

When I asked David what most helped him in the immediate aftermath of the miscarriage, he said, "When people asked me things, rather than told me things."

2. Prayer: 'Nuf said.

Waking Up Is The Hardest Part

"You are getting your PhD in grief." -- My mom, to me

In the last ten months I have lost my father and two children. I can say, definitively, that for me, waking up is the hardest part of grieving. I have always -- for better and for worse -- sought refuge in sleep, so even in the midst of tragedy, I am a sound sleeper. There is little worse than waking up from a deep sleep, and in those first flutters of consciousness remembering, "Oh, shit. That was not a dream." David and I found out on February 27 that this baby, like the one last summer, had not made it. I woke up the next three days sobbing when I realized the memory of the miscarriage wasn't some messed up nightmare, but our reality. I had this same exact experience in the week or 10 days following my dad's death: wakefulness, consciousness, heartbreak.

February 27 was a day of sickening deja vu. Being at the radiology clinic almost 11 weeks pregnant, a pessimist and worrier of the highest order hoping that my bleeding would turn out to be the spotting that about one-third of women experience in a pregnancy. I knew the minute I saw the ultrasound that we were in trouble. Again. You then have to endure the worry for your spouse, the "I'm sorry's" from the doctor, the getting out of the clinic and into your car while sobbing or trying not to sob in public, all the while passing women with swollen bellies or children already born. I am so over crying in public now, which is part of the PhD in grieving. My crying comes in waves. Sometimes I'm fine, sometimes I collapse in a heap, and that can be in my kitchen, if I'm lucky, or if I (and others) aren't so lucky, I might be in public. I've learned that the best thing I can do is let it come, wash over me, and then fade away. The more I try to fight it or stifle it, the longer it'll stick around. So I surrender to the crying, even if I look like the crazy person on the bus.

The bad deja vu continued with the consultation with our obstetrician followed by the D&C at Sibley, although this time it was less nerve-wracking since I knew what to expect.

Blimey, what can I say about this? There are so many feelings, all of them personal, though I'm pretty public, if you haven't noticed. One thing I can say with surety is that I am pissed off at God. This is not a feeling that is helped by the rapidly-depleting pregnancy hormones leaving my body; you get postpartum moodiness without the postpartum joy of a kid. I got enraged seeing David pray on February 28. I said, "It pushed my buttons seeing you pray to a capricious, cruel God." He had a brilliant and true response: "You don't know what I'm saying to Him." Someone left us a voice mail in the days after the miscarriage commending David and me on our faith and expressing some envy of it. I was thinking, "Are you fucking serious?!" Me, whose spirituality after this event ranges from giving God the Silent Treatment to cursing at God?

I don't feel bad about this in the slightest, by the way. I think God can handle my wrath, and Yisroel (Israel) doesn't mean "struggle with God" for nothing. I just see this as continuing my Jewish tradition of fighting with God. I have told my Jewish spiritual teachers that I am pissed at God, and they all say, "Sounds about right. You should be." I only went to services on Purim night to support my husband performing in the shpiel; I survived being there by knitting through the entire megillah reading [reading the book of Esther]. It was that or Xanax, kids, and I chose the non-pharmaceutical approach. I was ok there until I recited mourner's kaddish for my father, the memorial prayer for the dead, and became wracked with grief over the child we had just lost. I felt like I was saying kaddish for him or her too, and it completely knocked me off my feet. If I had thought about it before hand I probably could have anticipated this, but I didn't, and it bowled me over. Once again, the crazy lady sobbing in public!

I went to services last night, and approached them with mixed feelings. Sometimes I just took comfort in the familiarity of the melodies and prayers. Sometimes I was the master cynic. For example, singing "Yedid nefesh, av ha'rachaman..." -- "Beloved of the soul, Father of compassion...," I thought, "Seriously? Father of compassion? Try again!" Sometimes I just thought, "You suck, HaShem," even as my heart acknowledged that I don't have all the answers, or access to the master plan, if there even is such a thing. I don't know, nor do I particularly care. My friend said to me of the miscarriage and my anger at God, "Sarah, this is not a matter of God. God wants life. We are fragile, biological creatures, and this stuff just happens." Perhaps she's right.

I have a lot more to say about this, including a pointed post about what to not say to someone who has miscarried! All of it is heartbreaking and awful, though I feel like I am finally coming back to life at this point. Laughter is coming more easily, the tears slightly more infrequently. I am starting to talk to people I was avoiding. I want to blog again; I was so sick during my pregnancy that anything optional went out the window, including writing.

I am trying to balance grieving a tremendous loss in a healthy, mindful way. I'm not avoiding the painful feelings by: staying too busy; numbing out with food, alcohol, or illicit substances; or engaging in self-destructive behaviors. I'm trying to give myself room to take care of myself while not sliding into outright depression. So, yes, I nap when I need to, but I also am getting together with supportive friends, working out as much as I can, and making plans for the future. It is truly a day at a time, and some days are better than others. Heck, some hours are better than others.

I want to close by saying that I am so thankful that David and I haven't gone through this alone. Our friends' and families' practical and emotional support has been invaluable to us. They have cooked meals for us, come to spend time with us, called/emailed/texted us, sent cards and flowers, and just generally been there for us when we've needed to cry, vent or talk. Many of my friends have helped me collect myself when I wanted to haul off on one of the many people who said something heartless to me in my grief. For all this and more, we are grateful. Loss of a pregnancy is hard enough to go through with the support of loved ones. We have so many friends who have miscarried and told nobody, and I can't imagine going through this alone. I'm grateful we don't have to. Love you all.