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Sarah Williams

Miscarriage and mental health: Sarah's story

Sarah is an architect and Associate Principal at Grimshaw, and a mental health lead for the practice.

One in four pregnancies ends in miscarriage and yet we don’t talk about it. We don’t talk about the pain, the emotion, the broken dreams, the feeling of failure, the physical and mental toll on body and mind. Instead, we don’t even tell anyone we were pregnant: we put on a brave face, we carry on at work, we hide behind sunglasses, empty smiles, and congratulate people on their pregnancy announcements, all while feeling hopeless inside.


I write this from a happy place. I’m extremely lucky. I now have three daughters and I realise many are not that fortunate. I am sharing my experience because I know how lonely and low I felt when the family I had always dreamt of seemed so out of reach.


‘There’s nothing there’… these were the words I remember whispering at our first 12 week scan. I had seen enough scan pictures on social media to know what our baby was supposed to look like, and instead all I could see was a black hole with nothing inside. The doctor turned to me and explained that I had what is known as a missed-miscarriage; the baby has died and yet your body hasn’t displayed any signs of this, so you are blissfully unaware that anything is wrong.


We were sent to the early pregnancy unit to arrange what would happen next. The early pregnancy unit is a place of heightened emotion; you are only there if you have concerns over your pregnancy, and you then either find out the worst news, or the best: there is no in between. It’s either sheer joy that your pregnancy might be OK, or utter heartbreak.

The next day I had a procedure under general anaesthetic to remove the pregnancy. Little did I know that I would spend the next three years in and out of that early pregnancy unit with its fluorescent strip lights, blue plastic seats and noisy water cooler. At each visit I would hope to be given the happy news, that I could be part of the lucky couple leaving with smiles on their faces, clutching a scan picture.


It was then that it hit me, physically I might have been better, but mentally I was nowhere near OK.

I didn’t tell anyone at work what had happened. I said I needed some time off for an operation and then less than a week later I went back to work. I remember dealing with a particularly difficult contractor on site and having to fight back tears because he wouldn’t change a construction detail: something I was totally used to and a situation in which I would normally thrive.


It was then that it hit me, physically I might have been better, but mentally I was nowhere near OK. However early you experience miscarriage, it is a form of grief; the moment you learn that you are pregnant you become a mother and then miscarriage snatches it away. A well-meaning friend once told me I was lucky I could get pregnant: I remember just crying and telling her there was no prize in pregnancy if you didn’t end up with a baby.


Miscarriage robs you of any joy in future pregnancies, you assume it will go wrong again. For us it did. We had more miscarriages, which meant more scans when they told us they were sorry but there was no heartbeat. It was all-consuming, and yet I still told no one at work and only a handful of close friends and family. I was convinced that if I told my boss (at a practice before I joined Grimshaw), that I would be passed up on promotion opportunities: that somehow, they would think I wasn’t committed to my job. So instead, I put on a brave face and struggled on. With hindsight I wish I had spoken to people I trusted at work.


The problem is that no-one talks about miscarriage, it remains a taboo subject. It is a very isolating experience, but by talking to people, you will realise you are not alone.

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