Physique Picture After Miscarriage and Infertility: How To Get better

The worst moment of my life came at approximately 1:30 PM on July 10, 2023, when I realized my baby was dead.

I was lying in the ultrasound room, holding my husband’s hand. We were staring at the large projector screen, showing the inside of my uterus. At our last appointment, we got to joyfully glimpse our little one (named Forrest) moving around, and hear the miraculous sound of her heartbeat. But that day, at 14 weeks pregnant, there was only silence. It was a type of silence that I had never experienced before—a type that made me feel like I was dead, and more alone than I’ve ever felt in my 35 years of living.

After sitting in that terrible silence for what felt like eons, I had to break it. “Is everything okay?” I asked. The question feels ridiculous now, but at the time, part of me could not accept reality even when it was staring me in the face. My midwife responded with the worst words ever spoken to me: “No. I’m sorry, but your baby doesn’t seem to be alive anymore.”

I had a silent miscarriage (also called a “missed” miscarriage), which is when a baby dies in the womb without any of the typical symptoms of miscarrying like cramps and bleeding. My body still acted and felt as if I was pregnant, making the news all the more shocking and devastating. Like many miscarriages, ours was unexplained—and we were told it was simply bad luck.

After my miscarriage, I felt completely betrayed by my body, and like all the trust I’d built with it was broken.

My husband and I spent the rest of the week figuring out with our health-care providers how the pregnancy would end and how Forrest’s body would leave my body. It’s impossible to express exactly how I felt in the following moments, days, and months, but it was something like being stuck in a nightmare with absolutely no sign of waking up from it. I went from being shocked to infuriated to scared, and then headfirst into grief, which I am still processing now.

There is, of course, no possible way to prepare yourself for a miscarriage. But what most surprised me in the aftermath was how much I struggled to reconnect with my body. After years of neglecting my body through under-eating and over-exercising, I spent a lot of time as a young woman making peace with my body and learning how to befriend it. A large part of my life’s work as a dietitian has been devoted to helping others to heal from their own eating disorders and re-establish trust and acceptance with their bodies. But my miscarriage was foreign territory, and I found myself having consistent difficult thoughts and feelings toward my body for the first time in many years. I felt completely betrayed by my body and like all the trust I’d built with it was broken.

Throughout my life, I’ve heard about women struggling with their changing bodies in pregnancy, but never about how miscarriage or infertility impact body image. I can’t help but wonder if this is because those topics are still so culturally taboo that they’re discussed way less than pregnancy in general. There’s also significantly less research surrounding body image changes during these life phases compared to body image in healthy, full-term pregnancies.

But the silence on this topic does a disservice to the many of us who experience infertility and pregnancy loss. Ten to 20 out of 100 known pregnancies, or 10 to 20 percent, end in miscarriage. About one in five women in the U.S. experience infertility. I know several women who’ve experienced both. These experiences happen within our bodies, so of course they are going to impact how we feel about our bodies. Yet many of us aren’t prepared to navigate those feelings on top of everything else.

How miscarriage can impact a woman’s relationship to her body

After my loss, I felt like a stranger in my own body. I was scared of being alone with it—even on my yoga mat, which had been my safe place for over 15 years. I felt like my body failed me. I no longer viewed it as strong and powerful, but instead as disappointing and deeply flawed. My body had taken life from me, along with hopes, dreams, excitement, and innocence. I saw it as the former, empty home of my daughter and wasn’t sure I could ever trust it again.

Many people who miscarry grapple with similar feelings. “In my personal experience, I struggled to trust my body after my first of two miscarriages because I felt broken and angry that my body couldn’t work ‘correctly,’” says Arden Cartrette, founder of The Miscarriage Doula + Co. A small 2022 study in the journal Healthcare found that women who went through late pregnancy loss (after 10-14 weeks of gestation, just like me) described feeling disassociation, a loss of control over the body, and emotions like betrayal, distrust, and anger towards the body. “Both women and fetuses were described as hostages of the body,” the study authors wrote.

All the embodiment work I’d done to be in sync with my body in my recovery seemed pointless, since it hadn’t communicated a thing to me about my baby dying.

The body changes I’d experienced so far, like bigger boobs and a bit of a growing belly, were also disorienting, a constant reminder my baby was gone. “I struggled with my own body image as people continued to ask if I was pregnant while I held onto the ‘pregnancy weight,’” shares women’s health dietitian Jamie Adams, RDN, RPYT, who also had a missed miscarriage.

Despite being 10 years in recovery from my eating disorder, I also started to notice eating disorder thoughts popping up. This wasn’t necessarily a surprise to me, as I was in serious emotional pain and my old go-to was controlling my food and exercise. I was able to let the thoughts pass with the help of the tools and coping mechanisms I’d gained in recovery. But the fact that they came up at all made me feel like a fraud. I’d spent years healing my relationships to food, body, and exercise, and getting my health to a place where I could have children, and it felt like all that was a waste. All the embodiment work I’d done to be in sync with my body in my recovery seemed pointless, since it hadn’t communicated a thing to me about my baby dying.

In my work as a dietitian, I see a clear connection between mental health struggles like anxiety, depression, and emotional distress—all of which happen at higher rates to women who have miscarried² than those who haven’t—and worsened body image. A feeling like sadness, for example, may get funneled into negative body thoughts because it feels easier to bash your body instead of feeling and processing the sadness. That’s certainly how things played out for me after my own pregnancy loss.

The toll of infertility on body trust

Like miscarriage, infertility can significantly impact a woman’s relationship to her body. Cartrette says she struggles with resentment towards her body, and sees it in some of her clients, too. “I don’t ovulate on my own, which has always impacted my relationship with my body because I can’t have a spontaneous pregnancy, there are no surprises for my husband or myself, and we must spend a lot of money to get pregnant in the first place,” she says.

There’s also research showing high levels of infertility-related stress are linked to poorer body image³. “There are so many things that have to be ‘right’ for a pregnancy to occur and for that pregnancy to equal a healthy, living child, and when it’s not happening but a woman sees friends, family, and coworkers growing their family seemingly without a problem, it can make her feel like something is wrong with her,” explains Cartrette. “The more we feel disconnected with our bodies, the more blame we might place on them, but this can also lead to a disconnect in future cycles and pregnancies.”

Adams says that some fertility treatments and hormonal medications can cause appearance and body changes and weight fluctuations, which is a struggle for many of her clients. Plus, research shows infertility can negatively impact women’s self-esteem, sexuality, and psychological function⁴. “My female clients facing infertility describe to me feeling at war with their bodies,” says intuitive eating counselor Katie Schimmelpfenning, RD.

Sadly, some health-care providers can make everything harder. “[My clients] often unfortunately deal with weight-biased providers and harmful media messaging. These women describe to me being told to ‘eat cleaner,’ ‘lose more weight,’ and ‘be healthier,’” Schimmelpfenning says. This is despite the fact that multiple studies⁵ have shown that losing weight does not improve a person’s fertility⁶. “At every turn, these women are blamed for not being or doing enough to be worthy of pregnancy,” Schimmelpfenning adds.

“I find that there is also a lot of diet ‘advice’ out there that fuels this fire,” adds fertility and prenatal dietitian McKenzie Caldwell, MPH, RDN, “and makes folks feel as if dieting is the answer to their fertility issues.” You can see it on TikTok and other social media platforms, as influencers share nutrition plans promising people restored fertility—plans that often entail cutting out entire food groups or taking expensive supplements. But restricting food or punitively exercising to gain control and manipulate the body can lead to issues like disordered eating—which can further compound a person’s body image challenges and impact their health.

Cartrette adds that infertility or pregnancy loss can bring people back to a time where they weren’t at peace with their bodies—something I definitely noticed post loss. “If you’re someone who has a history of OCD, disordered eating, or weight concerns, fertility issues can really trigger the trauma that already exists in your mind.”

Steps to restoring body trust after pregnancy loss and infertility

Following last year’s loss, I gave myself time to repair the ruptured relationship with my body and used my tool kit of resources every day (and still do). Eventually, I realized it wasn’t my body’s fault or my body that caused the loss of my first child. Once I was able to accept it, I understood that staying mad at or ashamed of it would only keep me stuck.

As I often tell my clients, hating or resenting your body only makes it harder to take care of it. My body needed me to show up for it and help it to heal, because it was literally the site of significant trauma. We needed each other to get back to living again, and eventually to prepare for a new pregnancy.

This didn’t happen overnight, or on my own. There was no way I could’ve learned how to re-establish body trust and respect post-miscarriage without such a tool kit, and the help of others. So I wanted to share the practices and resources that helped me most after my pregnancy loss:

1. Give your body time to heal

Recovery from pregnancy and fertility treatment takes time, regardless of the outcome. Your doctor will give you specific guidance on when to return to your normal activities, depending on your body’s responses and side effects. For me, giving my body space to heal after my miscarriage meant sleeping and resting in abundance first, and then slowly getting back to regular physical activity, starting with gentle practices like restorative yoga and walking. The emotional toll may require more physical rest, because our emotions are felt and stored in our bodies. Giving your body time to heal is one way to show it respect and love, even if you feel at odds with it.

2. Offer yourself stability

Whether you’re struggling with pregnancy loss or infertility, everything can feel incredibly unstable and out of your control. It doesn’t help that much of the nutrition and health messaging about reproductive health is often a source of body shame. “In my work as a weight-inclusive dietitian, I help my clients tune out the noise, and we focus on listening to body cues and adding in nutrient dense foods, instead of cutting things out with a restrictive diet,” Caldwell says. By focusing on factors you can control in healthy ways—like nourishing your body with balanced meals and snacks every few hours, hydrating it sufficiently, moving it in ways that feel good, and resting it adequately—you’re providing it with stability and creating a safer environment within.

3. Write down how you feel

Writing in a journal can help you process your emotions related to miscarriage or infertility in a healthy way and help you to release any difficult feelings you have towards your body. I used a miscarriage grief journal with specific prompts to answer and found it to be a helpful tool in my healing process. Adams encourages validation of hard feelings when going through infertility issues, like frustration, disappointment, and grief. With loss, she says it’s only human to “feel a range of emotions after experiencing a miscarriage and normalize any feelings of grief, guilt, anger, or sadness.”

4. Seek out professional, guided help

“Mental health therapy is what I recommend for my clients first and foremost—miscarriage is a trauma and working through that with a qualified professional will get to the root of what’s behind the food and body image difficulties,” Caldwell says. Personally, without starting back weekly sessions with my psychotherapist and finding specialized support through the Miscarriage Doula (an organization of bereavement doulas who offer groups and individual sessions for women struggling with miscarriage and infertility), I’m not sure how I would have made it through the months after my loss.

One of the most effective tools in my healing process was a somatic (body-based) trauma therapy technique called Eye Movement Desensitization and Reprocessing (EMDR). It’s a process prompting you to focus on your traumatic memory while simultaneously experiencing bilateral stimulation (visual, auditory, or tactile stimuli which occur in a rhythmic left-right pattern), which is linked to reduced vividness and emotions associated with the memory. By the end of one EMDR session, I no longer felt like I was re-experiencing the events of July 10, 2023, every time I thought about my miscarriage. Instead, it simply felt like a sad memory from my past.

“Many of my clients have found therapies like mindfulness and EMDR to be helpful to pair alongside the work we do in nutrition sessions,” Caldwell adds. Working with a non-diet and weight-inclusive dietitian can also help significantly with healing your body relationship.

5. Practice self-compassion

Cartrette suggests women dealing with infertility or pregnancy loss spend “at least five minutes in the morning or evening—specifically right when you get out of bed or right before you get in bed for the night—looking at yourself in a mirror and practicing self-compassion. Be kind to yourself, look at yourself like you’re a friend going through a difficult time, and don’t be afraid to openly feel any emotions that come forward.” Also, try recognizing your big, hard emotions are not you but something you’re experiencing, and you’re not alone in feeling this way.

6. Integrate mindfulness practices

Experiencing both miscarriage and infertility can be dysregulating for your nervous system—I vacillated between a fight or flight state (sped up) and a freeze state (checked out)—and mindfulness practices were one tool to help me find a more constant state of nervous system regulation. Once I was ready to step back on the mat, gentle and restorative yoga combined with breathing and meditation practices helped me start turning back towards my body in a patient and kind way.

7. Expand your resources

Some of my favorite resources to support your body healing process include the book Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff, because self-compassion feels unnatural to many of us yet is necessary when going through the pain of pregnancy loss or infertility. Two of my favorite workbooks are The Embodied Healing Workbook: The Art and Science of Befriending Your Body in Trauma Recovery by Catherine Cook-Cottone, which is a thoughtfully-guided workbook to help you work through traumatic times, and The Intuitive Eating Workbook by Evelyn Tribole and Elyse Resch, a wonderful, interactive introduction to intuitive eating.

If you’re looking for non-book resources, Schimmelpfenning recommends The Body Grievers Club Podcast and Cartrette suggests exploring websites like Rescripted and Fertility Rally.