Cross-sector collaboration is the missing piece in combatting miscarriage trauma

Ahead of International Pregnancy and Infant Loss Remembrance Day 2021, Samantha Payne, CEO and co-founder of Pink Elephants, reflects on the need for a concerted cross-sector push to eradicate the poor mental health outcomes associated with miscarriage.

Miscarriage affects one in three Australian women, making it one of the most prevalent health issues in our society. And yet, miscarriage is still shrouded in a deafening silence that tells our community your experience of loss isn’t real, it wasn’t really a baby yet – it happened so early. 

This silence is pervasive across workplaces, health services and communities, creating a disenfranchised grief experience for bereaved parents. It can make women and families experiencing miscarriage feel isolated, unsupported, ashamed, confused and broken – all while dealing with the loss of their wanted baby. Which then leads to very real poor mental health outcomes such as anxiety, depression, post traumatic stress and suicidal thoughts. 

There are clear guidelines and protocols in place for many other common health issues in Australia, but miscarriage is not one of them. Whether that’s the steps taken after a cancer diagnosis, or how the system can best help someone suffering from a mental health issue, miscarriage is at best an afterthought in a general strategy. It’s not properly addressed on a national scale by the Department of Health, partly because of a total absence of government funding to specifically address the issue of miscarriage. 

It’s clear that once an issue gets funding and action, this equates to it being taken seriously in the wider community. Some states such as QLD Health do have guidelines but these are also not always followed through in practice and we still hear stories of women suffering with a lack of validation of the true impact of pregnancy loss or a clear referral for support by a health system that is failing them. 

Miscarriage is sadly a journey many women feel they have to navigate alone, as there is a huge gap in terms of clear referral pathways to early intervention support in place. Often once you’ve left the GP or the ultrasound technician’s rooms, this marks the unceremonious end of not just the pregnancy, but the formal support received in processing this loss. And it’s simply not good enough. A recent survey from The University of Melbourne showed 88 per cent of women want a referral for peer support from their healthcare provider following a miscarriage.

At Pink Elephants, we hear stories every day in our online communities of women who are miscarrying at home alone with nowhere to turn to for support. Women miscarrying in horrific circumstances in emergency departments is not an uncommon experience. Their baby has died and they are met with “at least it happened early” or “miscarriage is common, they happen”. We can do better and we must do better. The approximately 283 Australian women each day devastated by the words “I’m sorry, there is no heartbeat” need us to do better. 

Supporting legislative change is only the first step 

The federal government Department of Health, state departments of health, local health districts, public health networks, have all so far failed in their duty of care for women who miscarry. Organisations like Pink Elephants are under-resourced without the ability to meet the demands for our service or to deliver the types of service we know women and their partners need. 

Recently, our community had a win. It was the historic change to the Fair Work Act in September 2021, which stipulates that all employers must offer two days paid compassionate leave to women who have experienced a miscarriage. Pink Elephants lobbied for this for three years. It also took an empathetic male MP Julian Simmonds, a father to two who had also lost babies to miscarriage. He truly understood the trauma and grief and helped us to champion this change. 

His wife Maddi said, “I think it’s really important because it is something people shouldn’t be embarrassed about. I think it’s the only kind of loss people don’t talk about. If someone in your family dies you don’t pretend you’re okay. You let them know that you are grieving and that you are sad, and I think the more people talk about it, the more sensitive people will be about whether or not you are planning a family, how it’s going and those kinds of things.”

But supporting legislative workplace change is only one step. We’ve come a long way in validating the real grief felt by families. But until there is proper funding for the vital services that provide support to those suffering miscarriage, there are going to be far too many women who fall through the cracks and continue to mistakenly believe miscarriage is something that must be endured in silence. We can no longer turn a blind eye to the very real psychological morbidity of those that are impacted by miscarriage grief. 

Action will only galvanise when everyone comes together

At the moment, there is no concerted cross-sector push to address this most vital of women’s health issues, and until that moment comes, we’ll continue to see a lack of progress. Women and their partners will continue to suffer the death of their baby alone, isolated and minimised by a lack of truths around the experience of miscarriage. 

 I firmly believe we need all these people to come together in purpose on this issue:

• Government must be there to provide the funding for research, healthcare professional training, and targeted early intervention peer and clinical support. 
• The private sector must invest in destigmatising miscarriage in the workplace by training to provide support and empathy to employees. 
• Third sector groups must collaborate for greater impact for the community we exist to serve, bereaved parents. 
• The medical profession must collaborate with community stakeholders and academics on establishing pathways to support for those suffering miscarriage: how can they access resources in the most efficient ways, how can their mental health be monitored and managed effectively after a miscarriage, and what post-partum care should look like after a miscarriage. 
• Academics should be funded and supported to better research into miscarriage, so we can deepen our understanding, challenge the false narratives and create impactful service delivery that women and their partners are so desperately seeking. 

If these sets of stakeholders could come together and agree on a common goal – to eradicate the poor mental health outcomes associated with miscarriage – we might finally see miscarriage taken out of the shadows, and bereaved parents given the validity they have so long deserved. 

I will continue to work in this space until this happens because I believe women and their partners deserve so much more than what they are currently getting. Pink Elephants will continue to advocate for the needs of our community because we have a vision of world where the experience of a miscarriage is met with empathy and understanding so that no one walks the journey alone. 

If anyone is seeking support on this issue please head to www.pinkelephants.org.au