Defence against the dark arts

The clocks have rolled back and they seem to have taken the easy optimism I’ve felt all summer with them. The middle chunk of this year has flown for me – one minute we were heading off on a spring holiday, the next it was baby loss awareness week again.

But now the nights are drawing in and the days feel more plodding, somehow. There’s not much news round these parts. We’re trying to move house. And we’re trying trying, too. Our lives are both entirely uneventful and also on the precipice of enormous change. We hope.

I’ve been thinking a lot about what you do in the meantime. Those in-between days, weeks, and months; the waiting hours that can weigh so heavily. So much of what’s written and discussed around miscarriage, infertility and loss focuses on the dramatic moments: the very worst days, the raw grief of blood and tears, the specifics of medical procedures and tests, the heart-in-mouth moment you get another positive test.

Yet, actually, these add up to such a small part of what you’re living with. The rest is much more mundane – by definition a string of non-events – waiting for ovulation, waiting to test, waiting for the next cycle, waiting to see if the next pregnancy sticks…

But all of this still requires effort – and often this effort is demanded of you long after the intensity and shock of grief has burned away.

More than a year on since our last miscarriage and I don’t have the same ferocious energy I did in the early days of all this (I will not call it a ‘journey’). It’s become more about getting through and how to keep plodding forward. After all, this has turned out to be a marathon, not a sprint, for us. A marathon without any mile-markers.

I’ve written before about coping in the immediate aftermath of a loss, dealing with bad days and compiled this list, based on other people’s experiences as well as my own, of ways to heal from grief and trauma.

But what about coping with the more prosaic things? How you manage your time. How you channel your attention. How you handle the boring, basic everyday decisions you torture yourself with (Coffee? Second glass of wine?) and the unwitting things that other people say (‘Any kids?’). These aren’t so much challenges rooted in grief, but they do still require thought and energy; they still snag, like brambles on a woollen hem.

By now, I’ve developed all manner of coping mechanisms, so I thought I’d turn them into a guide, of sorts. Not so much self-care as self-defence…

Trying to conceive

There are two approaches here: minimalist or maximalist. Sometimes, there is something that feels helpful about collating as much data as you can – taking your temperature every day, multiple apps, ovulation sticks, the works. It’s reassuring, it feels like you’re doing something, it gives the illusion of control. However, for me the security blanket of this all-out approach quickly starts to feel more like a strait-jacket. Sometimes the tests don’t work as they should. You go away for the weekend and forget your thermometer. It inevitably leads to anxiety, irritability, rigidity (for me, anyway). I know there are books out there that will tell you that the crucial days are ovulation and the day right before ovulation (true enough), and will offer exacting prescriptions on how to maximise your chances, but I’ve come to the conclusion that these books tend to be written by women who have not had to try to conceive for longer than a few months, and never repeatedly, after losses. Tracking and charting everything might seem reasonable and even enjoyably novel for a few cycles, but if you’re in it for the long-haul I just don’t think it’s sustainable. In fact, I find it becomes maddening.

So this time round, for the sake of my mental health, I’ve gone lo-fi. Just a simple period tracker app (as opposed to a fertility-focused one – again, it’s too much pressure, a daily reminder I can live without) and following what almost every reputable medical authority says on the matter: have sex every couple of days. In the past, this advice struck me as unsatisfyingly imprecise. After all, you know it’s not actually possible to get pregnant for most of the month and sometimes there is only so much sex two people who work full-time can manage. But, actually, after a while it starts to feel like the approach that takes up the least bandwidth. (It’s almost like the experts know what they’re talking about…)

Plus, this way, you give yourself something to graduate to, as you get increasingly impatient. We’ve been trying for a few months and I’ve started to think things like: ‘well, if it’s not this cycle, next month I’ll buy an ovulation kit’ or I’ll research books on fertility diets (I currently have my eye on this one). Again, illusion of control, illusion of moving forward. I cannot over-state the importance of those sometimes. But – and this, of course, is just my take – if you go all-out from the beginning, you quickly run out road for things to try ‘next time’.

I also do ‘not this month, then’ shopping. AKA the ‘fuck it’ purchase. Each cycle, I pick out something in advance that I’ll let myself buy if my period arrives or (if I cave early) I test negative. It’s generally something slightly frivolous that I probably wouldn’t have bought if I’d found out I was pregnant. This month it was this pair of shoes. Last month it was an over-priced yoga top.

Period days are also a perfect excuse for a fully-caffeinated coffee, a glass of wine and a rare steak or brie on crackers. A very chic friend favours a vodka martini and buying cashmere.

Other people

Have some stock phrases up your sleeve. Because hell is other people and there’s always someone who thinks it’s OK to ask about your reproductive status in a casual setting, isn’t there? A hairdresser. A taxi driver. Someone you’re introduced to at a wedding. Recently, while making small talk about the fact we’re moving, I was asked by someone I’d just met whether I’d ‘checked out what the schools are like?’

For common-or-garden ‘any kids/would you like children/when are you going to have children?’ queries I generally reply ‘not yet’ or perhaps an upbeat ‘we’re working on it’. It’s like a reflex. The second option also gives people a polite hint that perhaps they shouldn’t have asked what is really a very personal question in the first place.

A ballsier variation I keep meaning to try (and wish that I’d said to Mr OFSTED inspection over dinner) is: ‘That’s a sensitive subject, actually.’

As for other people’s pregnancies, I have a few tactics. Chief among them is the mute button on social media and the simple rule of not going to anything I don’t want to. I almost never go to the baby shower. But I do try to send a present, or flowers or a note. I think in some ways it’s the kinder thing for all concerned. They can relax, without having to worry about sparing your feelings and you don’t spend an afternoon feeling like the ghost at the feast (and then need a day to recover your equilibrium afterwards). I’m also not above booking tickets for something for the same date…after an invitation has arrived.

If shopping for baby presents for friends is too hard, send vouchers. Shopping online (preferably somewhere with a gift-wrap option that can send it to them directly) might be easier. Occasionally, as a compromise, I’ve resorted to buying baby stuff from brands or ranges that are giving a donation to pregnancy research or a loss charity. And if a good friend has just had a baby, you could always drop round a big bag of shopping (fancy biscuits, tea, cake, posh microwave meals) in lieu of a present.

Waiting

Waiting is harder than we give ourselves credit for. Amazing how the days after ovulation can slow to a crawling, molasses-on-Velcro pace. The best I have for waiting days is to fill them with as many things that you enjoy as possible: binge-worthy TV, a gripping book or podcast for the commute, a guilty-pleasure magazine, new recipes, hair-cuts, facials, day-trips, Friday almond croissants…Things that pull you back to the here-and-now and, ideally, give you a sense of ‘not enough hours in the day’.

Oh, also, I don’t keep tests in the house any more. This way I have to go out and buy one deliberately, which helps to delay testing by at least another day. And sometimes I find that in the cold light of day I can be disciplined enough not to buy one anyway. But if there’s one in the house, I will almost always cave and test optimistically early – which of course, even if it’s negative, I won’t believe because…well, it’s too early.

Also, I only ever buy a certain well-known brand of test that can give a result six days before your missed period. Because I know by now that any other option gives me loopholes to torture myself with: Maybe it’s too early for a digital test. Maybe this cheap supermarket test isn’t sensitive enough. If I squint I’m sure I can see a line…

Don’t. Do. It. To yourself. Plus, despite only buying the expensive tests now, I’m sure I’ve actually saved money this way.

Doubt

It’s the slow in-between days that have you questioning everything. Should I have more medical tests done? Should I stop drinking altogether (again)? Do I use too many chemicals in my toiletries and make-up? Are there other supplements I should be taking?

To minimise these kind of doubts, I find it helps to expose myself to as little ‘noise’ as possible. For this reason, I stay off the forums. It can be hard not to have your head turned when you read the endless, complicated supplement regimens of other people. (It’s for this same reason I try not to share the ins and outs of what I’m doing or not doing food/exercise/supplements wise, not that it’s very radical anyway). It just fuels fear that you’re somehow not trying hard enough.

By all means, take whatever steps and tests and treatments it takes to make you feel most comfortable. But don’t do it because someone else over there is doing it and because you’re afraid of what it means if you don’t do it, too. It doesn’t mean you want it any less.

Data and doctors are my answer to doubts. Don’t take health advice from anyone who isn’t a doctor (me included). Just because someone who has a big Instagram following has had a blood test for NK cells still doesn’t mean there’s good evidence for that kind of testing. (You can read more about it here, if you’re interested.)

For me, when I’m having a wobble over a second (OK, third) coffee, or whatever it is, it always comes back to this – I’ve done everything ‘right’ before and miscarried anyway. I’ve tried all sorts of evidence-lite voodoo. I’ve been tee-total for the best part of a year, I’ve done no caffeine, no gluten, no running, no food heated in plastic, no perfume and no manicures. And I’ve miscarried anyway.

Above all, the thing I’ve found that helps me feel sanest is living my life as close as possible to ‘normal’. Of course, after everything that’s happened, I’m never going to be the person who does tequila shots and stays out till 4am the week before my period is due or who runs 10ks while pregnant. I’m not exactly booking far-flung holidays with abandon or training for a marathon right now. I am careful with myself, but in moderation, within reason. It is really, really difficult not to go searching when there are no answers, I know. The way I try to think of it is this: If, in a year’s time, there is still no baby, how will I have wanted to have lived?

That’s a value judgment, so there’s no right answer. Sometimes the answer is that I’d have wanted to have tried as hard as I possibly could and that, put into that context, something feels like a small sacrifice – or worth the money. Sometimes the answer is that I would have preferred not to have made myself unnecessarily miserable.

It tends to quieten the doubting voices for a little while, anyway. And on we plod.

Please do share your own survival tactics in the comments, if you’d like…