Hosts Hilary Erickson, RN, and PhD student Kathleen Gunter dive deep into the emotional and mental health challenges that follow a miscarriage. Kathleen shares insights from her research on how women experience subsequent pregnancies after a loss, highlighting key themes such as emotional distress, fearful anticipation, and ambivalence. We explore the importance of social support and how healthcare providers can better assist during these difficult times. Join us as we untangle the complexities of miscarriage and motherhood.
Find it here on Apple or Spotify Podcasts
Big thanks to our sponsor The Online Prenatal Class for Couples — if you’re looking to navigate pregnancy with more confidence, it is the course for you.
Today’s guest is Kathleen Gunter — a Nursing Instructor and PhD student whose research focus is on maternal mental health following miscarriage. After experiencing a miscarriage with her first pregnancy, Kathleen developed a passion for helping other moms feel less alone as they navigate the emotional journey that follows losing a baby. Find her on Tiktok: https://www.tiktok.com/@balancedishchaos
Links for you:
Episode 227: Beyond the Rainbow: Pregnancy After Stillbirth with Winter Redd from Still a Part of Us Podcast
Timestamps:
00:00 Study on experiences of mothers after miscarriage.
05:57 Fear of causing harm during second pregnancy.
08:52 Women experienced ambivalence and emotional detachment in pregnancy.
10:17 Navigating loss and finding joy amid uncertainty.
13:31 “Social support crucial for healing after pregnancy loss.”
18:18 Supportive women can help during difficult times.
19:47 Stay tuned for more on Pulling Curls.
Keypoints:
- Introduction to episode 240 of The Pulling Curls Podcast, focusing on miscarriage and motherhood.
- Hilary Erickson, RN, introduces herself and the podcast’s aim to simplify pregnancy and parenting.
- Today’s guest, Kathleen Gunter, a PhD student researching mental health after miscarriage, is introduced.
- Discussion on Kathleen’s study of mothers pregnant again after a previous loss, which included interviews with 7 women.
- Identification of three major themes from the study: emotional distress, fearful anticipation, and ambivalence.
- Insights into the anxiety, worry, and hypervigilance women experience in subsequent pregnancies after a miscarriage.
- The tendency of women to reach certain pregnancy milestones and the emotional significance of these benchmarks.
- The impact of social support on mental health after miscarriage, emphasizing support from individuals with similar experiences.
- The importance of healthcare provider support post-miscarriage and the current lack of adequate follow-up care.
- Encouragement for women to openly discuss their experiences to find solidarity and support, both personally and within the healthcare system.
Producer: Drew Erickson
Transcript
[00:00:00.820] – Hilary Erickson
Hey, guys. Welcome back to the Pulling Curls Podcast. This week on episode 240, we are talking about miscarriage and motherhood. Let’s untangle it.
[00:00:11.140] – Hilary Erickson
Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and The Pregnancy Nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with Pregnancy and Parenting Untangled, The Pulling Curls Podcast.
[00:00:39.940] – Hilary Erickson
This episode is sponsored by the online prenatal class for couples. If you’re interested in clearing any previous birth trauma or just getting prepared for your birth, come join us in there. It truly is the easy way to get prepared for your birth. It’s available 24/7. It’s meant to turn your partner into a teammate, not just a cheerleader. And it’s the all-in-one birth class that people love.
[00:01:00.980] – Hilary Erickson
Today’s guest is a PhD student who’s research focuses on motherhood and mental health following a miscarriage. She has previously had a miscarriage of her own. I wanted to introduce today’s guest, Kathleen Gunter.
[00:01:13.870] – Hilary Erickson
Hey, Kathleen. Welcome to the Pulling Curls Podcast.
[00:01:15.890] – Kathleen Gunter
Hi, good morning.
[00:01:16.590] – Hilary Erickson
Good morning. I met Kathleen at the AWON conference.
[00:01:19.080] – Hilary Erickson
We sat next to each other in some session, and she was like, I love podcasts. And I was like, do you want to come on mine? Because she has a really interesting… Is it a master’s or PhD? Phd, right?
[00:01:29.100] – Kathleen Gunter
So I’m working on my PhD, yes.
[00:01:31.560] – Hilary Erickson
Yeah. And it’s your dissertation?
[00:01:33.280] – Kathleen Gunter
So my PhD is in nursing science, and my research focus is on… Currently, it’s on mental health and specifically the emotional growth in women following miscarriage.
[00:01:44.780] – Hilary Erickson
Yes, which is super interesting to me. I bet a large number of people listening to my podcast in general have had a miscarriage, just because most of the people I associate with online are saying they had issues with miscarriage and going forward in motherhood and pregnancy. So I’m so excited to have you on, Kathleen. Thank you.
[00:02:02.570] – Kathleen Gunter
I’m so excited to be here.
[00:02:04.460] – Hilary Erickson
Okay. What did you learn in your study?
[00:02:06.390] – Kathleen Gunter
Okay, so the study that actually am going to talk about today, that when we met at the conference, I was presenting the poster on this research that I had done, which is actually a little bit different than what I’m studying for my dissertation. But funny enough, it led me in the direction of what I wanted to do for my dissertation.
[00:02:23.040] – Kathleen Gunter
So this study that I did as part of a course during my PhD program, specifically was I’m focusing on the experience that mothers had in pregnancy following a miscarriage. So women who had previously experienced loss, and then they were pregnant again. And I wanted to figure out what was their experience in that pregnancy again.
[00:02:47.440] – Kathleen Gunter
Because me personally, I had a miscarriage back in 2018. It was my first pregnancy. And so I always say 100% of my pregnancies had ended in miscarriage at that point. My provider was a wonderful provider. But she even said herself, she said, Well, we don’t really get concerned until you have three or more. I remember thinking, But this is 100% of my pregnancies. You don’t care about it until I have two more. I have to go through two more for you to really care, which care is not exactly the right word. She cared.
[00:03:23.560] – Kathleen Gunter
That whole experience for me just lit a fire for me to want to talk to these women who have gone through this experience. Then I now have two children, actually. But I had experienced one pregnancy after my loss when I started going through the PhD program, and I was like, I really want to focus on that.
[00:03:42.700] – Kathleen Gunter
The study that I did in particular involved It was a qualitative study. I talked to a total of seven women. Funny enough, I ended up having over 65 women reach out to me. When I was recruiting for the study online, within 24 hours, I had over 50 women who wanted to talk to me, which alone shows you how many people just want to be heard and talk about what the experience is like.
[00:04:06.480] – Kathleen Gunter
I had over 50 people talk to me, ended up reaching saturation after only seven, which I was like, I’m so sorry, I can’t talk to all of you, but ended up only needing to talk to seven, and just talk to them about what their experience was like. What was it like to be pregnant again after experiencing loss? The study was very interesting.
[00:04:25.230] – Kathleen Gunter
We know that the research and the literature says that women who experience miscarriage have mental health conditions afterwards. Symptoms of anxiety and depression and post-traumatic stress are rampant in this population of women.
[00:04:38.930] – Kathleen Gunter
As part of the study, I found three themes. That’s the way that the qualitative study works, is you look for these themes when you’re going through the research and through the recordings of the conversations. The three things that emerged from the study was emotional distress, fearful anticipation, and ambivalence.
[00:04:58.030] – Kathleen Gunter
These women really had a negative emotional impact during the subsequent pregnancy as a direct result of their first loss. They were nervous, they were terrified, they had loss of hope, excessive worry. That excessive worry, that resulted in this hypervigilance and this anguish over anything that happened, any twinge or any pain. I can speak firsthand. I was the exact same way. Any twinge, I’d be like, Oh my gosh, something’s wrong. When really your body has all sorts of crazy things during pregnancy that are very normal. But when you’ve had that loss, you just assume that something’s wrong every single time you feel any something.
[00:05:38.940] – Hilary Erickson
Yes. And I see that so much in my groups online. Everyone’s like, they take everything as a sign. And I think they always are thinking back, what happened? What did I do last time to make this happen? And I got to reassure a lot of people that there was nothing that you did. It’s just how things happen so much of the time.
[00:05:57.310] – Kathleen Gunter
Yes, exactly. But when it’s your first one, especially, you just assume that it was something that you did, and you almost can’t be convinced otherwise. You cannot be convinced that it wasn’t something that you did. When that’s not true at all, it’s just easy to get in your head and wonder, Okay, well, what can I do differently this time so that I don’t, quote, unquote, cause it for this second pregnancy?
[00:06:20.030] – Kathleen Gunter
They had fear that they were going to lose their second pregnancy because they had lost it the first time. So often, they would just desperately voice this desire to protect themselves and protect the baby. And so they were relentless about not doing anything that would potentially harm themselves or harm the baby. So things that are doctor approved during a pregnancy, like exercise or sex or jumping too high or even certain skin care, they wouldn’t use it. And even though we knew that it was safe, they just were like, why didn’t want to do anything that would potentially harm the pregnancy.
[00:07:01.040] – Kathleen Gunter
Then something that I also experienced firsthand and was very obvious in the conversations with the women was that they just desperately wanted to reach those pregnancy milestones. They had to get to 20 weeks viability. They had to have reassurance through ultrasounds. Something that was interesting was every single person talked about how they just wanted to reach the week of gestation where they had lost the previous baby.
[00:07:29.430] – Kathleen Gunter
So from my experience, I lost my first baby at 10 weeks. And so I remember in my next pregnancy, when I got to 11 weeks, I was like, Oh, my God, I did it. I got past that point. But then there’s always a new goalpost, right? Well, now let me just get to 16. And then when I start feeling the baby, and then now let me get to 20. And then now… You always move the goalpost. But just reaching that point of gestation where the first baby was lost was a huge recurring theme that these women talked about.
[00:07:59.080] – Hilary Erickson
Yes. And I see see that so much in my group. And people are like, Well, once the baby is here, then I won’t have that. And I’m like, You’re going to have that the rest of your life. My kid’s 24, and I still am like, Oh, you’re going on a trip? Oh, you’re driving up just a couple hours away? And in my head, I’m like, And he’s going to die. He’s going to die in a car crash, so that’s too bad. I’ve had a good run with this one.
[00:08:19.650] – Kathleen Gunter
Yeah, exactly. And I don’t know if you know anything about Enneagrams, but I’m in Enneagram 6, and the definition of that is excessive worry and worst case scenario in catastrophizing. And so the combination of miscarriage and that personality, and now motherhood and that personality, it’s just I stay stressed and anxious all the time. But reaching those milestones didn’t necessarily fix that, but that’s just what it is, I guess.
[00:08:49.380] – Hilary Erickson
It helps make it better. I get it.
[00:08:52.460] – Kathleen Gunter
And so then the interesting, the third theme that I found was ambivalence. So these women who had experienced pregnancy after loss, they were so excited initially to be pregnant again. And then it was just almost immediately overshadowed by fear and dread. And they didn’t really know how to feel. They were confused, and then they often felt guilty about their confusing emotions. So they would be so excited, and then they would feel worry and anxiety, and then they would feel guilt because they weren’t excited. And women who had had multiple miscarriages, they all expressed that they emotionally detached from the pregnancy.
[00:09:30.120] – Kathleen Gunter
I remember one of the women that I talked to, she had had, I think, four or five miscarriages. And in her last pregnancy, she didn’t decorate the nursery until she was 38 weeks pregnant. She didn’t acknowledge that the baby was coming. She said the week before she got induced, she sat in the nursery and just cried because she couldn’t accept the fact that she was actually having a baby because she had lost so many.
[00:09:57.190] – Kathleen Gunter
And so this overwhelming void, almost, of emotion just to have some self-preservation. Because if you don’t get attached to the baby, then you’re not going to hurt when you lose the pregnancy, right? Which I don’t know if Brené Brown is somebody that you listen to, but She was really helpful for me as I walked through my experience, and she talks about vulnerability, and she talks about joy, and she talks about not letting the fear of life take away the joy of the moment.
[00:10:27.930] – Kathleen Gunter
And it’s hard to do that when you’re walking through loss, but it doesn’t hurt any less. Just because you prepare yourself for loss doesn’t mean you’re going to hurt less. It’s just almost accepting, Yes, I have had a loss in the past. I have no control over this current pregnancy now. But that doesn’t mean that I can’t find joy in the pregnancy that I have now, even if the outcome isn’t exactly what I want. I can love this baby for the time period that I have the baby, regardless of the outcome.
[00:10:59.950] – Kathleen Gunter
It was a very interesting study. It was very eye-opening. It actually turned, I mentioned earlier, it turned my focus from the subsequent pregnancy, actually, just to focusing on the miscarriage itself, because I started this study with the intent of expecting to find all these things in the subsequent pregnancy. All the women wanted to do was just talk about the loss.
[00:11:24.530] – Kathleen Gunter
All they wanted to do was just talk about the miscarriage experience. They’re like, Yeah, I was pregnant, and this is what I I experience, because you’re asking me these questions, but I actually just want to talk about the loss.
[00:11:34.310] – Kathleen Gunter
That’s how I pivoted my research focus to, Okay, what is it about the miscarriage experience, specifically, that keeps these women wanting to go back and talk about that? What did they not get during that miscarriage experience that would have helped them heal? What would have been beneficial for them to receive? Anyway, so that’s how I ended up pivoting my focus for my dissertation study itself.
[00:11:59.410] – Hilary Erickson
Yeah. When I read books from back in the old fashioned days, the women didn’t even attach to these babies for a year. They had a baby and they were just like, We’ll see. When you get a plant and you put it in the ground, if you’re not a green thumb like me, you’re just like, I’m not attached to this plant because there’s a good chance it’s not going to make it.
[00:12:20.020] – Hilary Erickson
I feel like women in pioneer times or medieval times just were like, We’ll just see. We’ll see if that ends up being a thing. And I- obviously we don’t want that in our moms today. We want them to be able to attach the baby during pregnancy. A lot of times I see people with ultrasounds. They go to the ultrasound, and the ultrasound tech is so medically about it. And I’m like, The ultrasound is such an important part of seeing that baby is seeing the baby’s a human, bonding with the baby during pregnancy so that you can build up those feelings and be a great parent once baby comes out. So I think it’s so important.
[00:12:54.920] – Kathleen Gunter
Yeah, I completely agree. Every step throughout the pregnancy, there’s purpose behind it, and it gives you just every opportunity to bond. And it’s been a really interesting and really eye-opening. And I have absolutely loved my research that I have done so far, and I can’t wait to do it for the rest of my career.
[00:13:19.260] – Hilary Erickson
Yeah, that’s amazing. So is there anything that women did when they were feeling these feelings that could help? Because I bet the people on here are like, Okay, great. Yeah, I feel like that, too. But what am I supposed to do with all those feelings?
[00:13:31.220] – Kathleen Gunter
Right. Yeah. So the study that… That study, specifically, didn’t talk… I didn’t dive into any of the recovery part of it. But through my dissertation research, I have studied a lot about what can help, quote, recover, and how can we heal through all of it. And one of the major things that I’ve looked at is social support. So I can’t tell you specifically social support in the subsequent pregnancy, but I’ve done a lot of research on social support following miscarriage, specifically.
[00:14:03.970] – Kathleen Gunter
There’s just so much research to back how important that social support is, whether it’s from… Research shows that the highest or most effective form of social support is going to be from individuals who have had a similar loss. So talking to women who have also had a miscarriage, or if it’s a stillbirth, talking to women who have also had a stillbirth, walking through that with them because they can empathize, and you can empathize with each other, and there’s nothing that’s going to take that hurt away. But having those people around you who can just hold your hand and walk through it and understand how painful it is so, so important.
[00:14:41.050] – Kathleen Gunter
So social support increases at least a better mental health, better physical health, and improved quality of life. Through support groups or friends or family that have had a similar loss, partner support doesn’t typically show to be as effective as who have had a similar loss, but it’s just different. Your partner is there to be a Sounding Board as well in a different way than women who have had that similar loss. Really just talking about it, finding your people that you can talk to about it, who understand what you’re going through.
[00:15:13.120] – Kathleen Gunter
Then another really effective form of support was being a sounding board for women who are following behind you. So anybody who you find out has had a miscarriage, opening up and saying, Oh, I always say it’s you don’t want to join, but it’s a huge club of women who hate to be in it but are glad that there are other people in the club with you. Just finding those people and you being that person for somebody else, too, when they have experienced a miscarriage after you. And then interestingly enough, there’s a lot of research that shows how important that support is from health care providers.
[00:15:54.700] – Kathleen Gunter
And unfortunately, there’s not a lot of support from health care providers in this particular situation. There was a research study actually done in 2021, and nearly 60% of women… I think there was about 400 women in the study, and nearly 60% of those women were offered no support after they experienced a miscarriage. And only 37% of the women actually even receive follow-up care at six weeks. So it’s an area that has a huge gap and lots of room for improvement.
[00:16:28.780] – Kathleen Gunter
And it seems, you know It affects so many people. It affects so many women. There’s just not the care that we need, the follow-up care post-loss that we really need. I think just verbalizing and being very specific about talking to your health care provider, I need to see you again at six weeks.
[00:16:46.080] – Kathleen Gunter
Your body’s going through a mini postpartum experience. You’re still having all of the hormones. Just being very vocal about, This is what I need. I want information on support groups, being willing to talk about it. It’s hard to talk about, But research shows that you heal and your mental health is so much better when you talk about it.
[00:17:06.940] – Hilary Erickson
Yeah, I think that’s so true. And I had on the podcast my friend Winter, who runs the podcast Still A Part Of Us, that’s about stillbirth and Infant Loss, that people might find helpful if they’re not wanting to go to a support group. But I think an in-person support group is obviously probably the gold standard for that because it’s friends you can meet for coffee in your community.
[00:17:25.660] – Kathleen Gunter
Exactly. And there is a lot of people at the conference in Phoenix that I had support groups in various different states that I always ran into their table, and I was like, Tell me more about your support group. So, yeah, finding those people is so important.
[00:17:40.070] – Hilary Erickson
Yeah. And hopefully, we, as health care providers, can get better. And the more you voice what you want, Because a lot of people just want to forget it, right? That’s what we’re thinking. And especially during the minutes that you’re in the health care setting, you want to forget those minutes for the most part. And so if we get better, and the more you ask, the more we’ll be like, Oh, this might be some the information, I want to volunteer. You can help us get better when you voice what you want. I always try and remind people that.
[00:18:05.610] – Kathleen Gunter
Exactly.
[00:18:05.890] – Hilary Erickson
Yeah. Well, great research. So helpful. I think it’s so important that people not feel alone in this and realize that other people are struggling, too. And that this base is large. I think the majority of people that are pregnant have previously had a loss. Oh, yes.
[00:18:19.740] – Kathleen Gunter
Very wide range of women who could use all the support possible out there and know that they… I think the biggest thing is just to remember that you are not alone. People don’t want to talk about it. I think that’s getting better. People are more willing to talk about it these days than they were previously, but it still almost seems taboo.
[00:18:39.450] – Kathleen Gunter
Just remember that I guarantee anybody who is going through this, if you just open up and mention it, there will be women probably around you who have gone through the exact same thing that you didn’t even know that they had gone through it. And so finding those people and being willing to talk about it, you will instantly, I’m certain, be surrounded by supportive women.
[00:19:01.590] – Hilary Erickson
Yeah. Well, thanks so much for coming on, Kathleen. I think this is great information. And people can always join us on Instagram. If you guys have found great support somewhere, please come tell us on Instagram so other people can find that support elsewhere.
[00:19:14.170] – Kathleen Gunter
Sounds great. Thank you so much for having me.
[00:19:16.630] – Hilary Erickson
Okay. I hope you guys enjoyed this episode. I wish that no one needed this episode, but in my groups and on Instagram, I feel like this is needed more than anything else. So when I heard what her dissertation was on, I was super excited to have her on. And I I hope you guys enjoyed it. Again, please come join us over on Instagram. If this brought up any feelings or thoughts. Come join us so we can have that chat over on Instagram.
[00:19:39.290] – Hilary Erickson
Stay tuned. Next week, we are talking about the scarcity mindset of parenting. And then the week after that, we are talking about things to do the day before your induction. So stay tuned.
[00:19:49.850] – Hilary Erickson
Thanks for joining us on the Pulling Curls podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.
Keywords:
miscarriage, motherhood, pregnancy, mental health, anxiety, depression, post traumatic stress, emotional growth, first pregnancy, subsequent pregnancy, pregnancy loss, pregnancy milestones, ultrasounds, support groups, healthcare providers, social support, partners, healing, mental health support, physical health, quality of life, stillbirth, infant loss, hormones, postpartum experience, research study, PhD student, nursing science, emotional distress, pregnant again, miscarriage experience
Leave a Reply