Episode 15: Early miscarriage

Dr.Sophia:
Hello everyone. Welcome to the Dr. Sophia Podcast. I'm an obgyn practicing for over 15 years in my native New York City, and I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we will talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more.

Hello everyone and welcome to the Dr. Sophia obgyn podcast. Today we're gonna speak on miscarriage. I actually thought about doing this podcast from a patient experience that I had, and so I'm so happy to be able to share with you my thoughts and this particular story. As always, I'm so happy and thankful to have my good friend and co-host Touseef Mirza with me.

Touseef Mirza:
Hi, everyone. So originally you came to me and we started to talk about miscarriage, but more on a personal level, which I think we don't talk about as much versus looking at it more from a medical perspective.

Dr.Sophia:
Yeah, definitely. So the concept of wanting to talk about miscarriage, first of all, I think it's important for us to even just define the term miscarriage. From my perspective, there's the broad term that means pregnancy loss that happens in less than 20 weeks. But I wanna get even more specific and really think about it as early pregnancy loss and that which happens, you know, even as early as 13 weeks or less because I feel like that is a completely lost group of women that are simply unsupported and a time that it happens so often. That's actually the time when miscarriage or a pregnancy loss happens the most.

You're less likely to actually have a loss in terms of a pregnancy after 14 weeks. And yet, you know, we're very sensitive to when we can actually see the baby bump and things like that. But there's a whole majority of women up to, you know, 20 to 25% of pregnancies that actually end in early pregnancy loss ends before even eight weeks of pregnancy.

Touseef Mirza:
So even when we say then, in terms of early pregnancy up until 13 weeks, some of us don't even know we're pregnant at that point. Correct?

Dr.Sophia:
There's definitely an amount of women who may not know that they're pregnant, you know, certainly, four weeks in or six weeks in, or even up to eight weeks in, because they may have some spotting that they associate as having a period in the early stages of pregnancy. Or they may be a woman who has irregular menses. And so therefore, again, they don't realize that they were pregnant because if they didn't get their period for one or two months, there's no real alarm per se. But certainly, you know, women who get their periods regularly and they miss it, it's like, ah, ding, ding, ding, ding, ding. Maybe I need to check.

Touseef Mirza:
Let's say after like four to five to six weeks, you start to say, okay, if you're not having your period, maybe there's a pregnancy involved.

Dr.Sophia:
I would say even just a week after you've missed your period, a lot of women are like, I think I'm pregnant. I don't think that it needs to even wait that long. However, what can happen after the first four weeks of pregnancy is that you can have something called implantation bleeding, and you know, you have other things that would make a woman feel confused.

Touseef Mirza:
Confused because it might look like a period, but actually it's not a period?

Dr.Sophia:
Exactly. But I wanna bring us back to this concept of early pregnancy loss because that's the majority of women experiencing loss. It happens in early pregnancy. And so we'll get a chance to talk a touch a little bit about, you know, some of the signs and the symptoms, but I can't wait to share this one particular patient experience that I had just earlier in this, this week and how it made me realize how little or no support we have for a big part of women who experienced pregnancy loss.

Touseef Mirza:
So tell us a little bit about how this journey started in terms of you connecting with this patient.

Dr.Sophia:
So the interesting thing is that she was a new patient to me, so I'd never met her before. And she was coming for what we thought was gonna be her annual exam. And then she, she then indicated to me, I believe I'm pregnant. And I said, oh, wow. That's, you know, that's great. And then I said, well, let's double-check. We did a pregnancy test, just a urine pregnancy test, and it was in fact positive. And when I asked her, well, when was your last period? And she said, you know, she gave me a date, and based on her last period, she should have been, let's say nine weeks pregnant. And then we go through all the motions, we're super excited. She's actually been planning for a pregnancy. She's like, so happy. We're talking about, I start asking her, well, what are the symptoms you're having?

Are you tired? Are you nauseous? Are your breasts tender? Have you had any bleeding? To which she responded that she definitely was having some fatigue, that she absolutely was having some breast tenderness, and that she had not had any bleeding since her last period. And that she only had had some nausea like earlier the week before. And so I said, oh my gosh, this is all great. Those are great. That's great news. What women don't realize is that sometimes having all those pregnancy symptoms when you go to your doctor is like a good signal to me that the pregnancy is in the right place and that it's actually a growing pregnancy. And so we go through the motions of the rest of the visit and I say, okay, well let me see if my sonographer is gonna be able to see you today. So that way we can confirm the pregnancy

Touseef Mirza:
Sonographer is when you're able to, to actually see-

Dr.Sophia:
Right. To get her to be able to see the pregnancy on ultrasound. Then she goes to get the ultrasound, and then the sonographer comes back to me and is, and says to me, she's measuring about, you know, eight and a half weeks, but I don't see a heartbeat.

And oh my gosh, I just fell and I haven't even seen the patient back again. Now she's gonna come back to see me and I have to sit, and then I have to break the news to her. But in that instant, I just was like, but we were just so happy.

Touseef Mirza:
We shared this beautiful moment.

Dr.Sophia:
We shared this great moment of being excited about the pregnancy and that, you know, it was planned. And she even got a chance in that moment to say that I hadn't even told my husband yet. And I was like, oh, great. We're gonna be able to give him even better news today that you, you know, you're pregnant and everything is going well, you know, and then it felt like a ton of bricks, you know, of having to then say, yes, you are in fact pregnant, but it looks like you're having a pregnancy loss.

Touseef Mirza:
Wow. That must be such a difficult thing to say to someone, especially after you share a moment together of joy right before.

Dr.Sophia:
So it's not to say that a moment like that hasn't happened to me multiple times or before or what have you, but this woman was just, she already knew she was pregnant when she came to see me. She wanted to get confirmation. I thought I was gonna be able to give her that. And, and it, and everything sounded like it was going in the right direction just based on what she had told me. And so here she is a new patient, and I'm meeting her for the first time. I'm excited because I get to give her good news. And in an instant, I now have to give her bad news. This is happening all on the same day, not just on the same day, but in the same 30 minutes. You know, all in the same, such a short, small period of time of having to go through every piece of that emotion.

Touseef Mirza:
What was her reaction?

Dr.Sophia:
Well, first things first, she was shocked. And after the first 30 seconds of wait, what did you say? What does that mean? And then having to say, I'm sorry that the pregnancy is not gonna continue, because it stopped growing and I'm so sorry. At that moment, I just had to give her time because she just started crying immediately.

Touseef Mirza:
Probably she never even thought of that.

Dr.Sophia:
That is correct. The possibility that the pregnancy would stop growing. This is her first pregnancy too. This is not like, it's not like she's been there before, done this before. And so the possibility of it not actually surviving or not being viable, meaning that it's gonna actually continue to grow into a full-fledged pregnancy and, and, and, and a baby at the end. Right. But I'm sure, like for her, the second she got that positive pregnancy test, you're already thinking of baby names even sometimes, you know, especially when you're planning a pregnancy. So the concept of knowing that you're pregnant after you've been working on it, and you're so excited that it's gonna happen. And so yeah, of course, she's not thinking that it's not gonna survive or that there's a problem with it. And so at that point, it's, how can I support you in this moment? How can I help you just get through this moment in time of ultimate sadness all of a sudden?

Touseef Mirza:
I mean, the fact that the person is shocked and then is in disbelief. I don't even know if you can even understand what you need at that point. Right? It’s just-

Dr.Sophia:
Holding her hand.

Touseef Mirza:
And she came by herself?

Dr.Sophia:
And she came by herself. She came by herself. I mean, it was supposed to be your typical annual exam.

Touseef Mirza:
Right.

Dr.Sophia:
You know, like, I don't know. I don't bring my friends. But in all seriousness and in terms of the next steps, I then, now as the provider, I'm thinking, okay, I have to have a conversation with her now on what are the next steps for her. What is she gonna feel more comfortable with? And presenting her with all of her options now, now that we do have this information. And that included talking to her and saying, do you want to go home? Is there anyone I can call? Is there anyone who you can come and meet you here right now that you'd like to talk to about what's just happened? And we can talk about your options tomorrow. We can talk about your options next week.

Touseef Mirza:
In terms of what to do.

Dr.Sophia:
In terms of what to do, and how to manage.. Because you've gone through this shock and this disbelief. Now I have to then tell you, oh, and by the way, do you wanna just wait and let it come out? Do you wanna just, do you want me to give you medication? Do you want me to have surgery? Like, it's just too much.

Touseef Mirza:
That's a lot. It's way too much.

Dr.Sophia:
Just too much to try to process all in this short amount of time.

Touseef Mirza:
It's like your whole future just vanishes.

Dr.Sophia:
In an instant.

Touseef Mirza:
In an instant. And now you're in this other world and nothing makes sense

Dr.Sophia:
And nothing makes sense. And so I did offer for her to come back and, and we can talk about whatever the options and the things that's gonna work best for her at another time. And to see if she can, if her, if her husband could join her in that, in that moment. Or she had anybody that she'd want me to call and she said, no let's just talk about it and figure out what we're gonna do/

Touseef Mirza:
Right then and there?

Dr.Sophia:
Right then and there.

Touseef Mirza:
That's pretty brave.

Dr.Sophia:
Listen to me, we women are powerful and brave and courageous and we go through a lot. And yeah, I was proud of her to be able to think about that in that moment and say, okay, now how do I, how do we move on? What is the next, what are the next steps? And so the next steps include options. Options for a pregnancy loss that occurs at eight weeks include just allowing your body to naturally go through the process. Eventually, she would have some spotting, then bleeding, then heavy bleeding. Then I have to do without any medications or anything. We typically give up to four weeks actually for your body to recognize that this is the process that it has to go through. The second option is to give some medication that would start the same normal process that the body would go through, but to kind of hasten it.

So make it so that you can actually, let's say, pick the best time. Maybe it's the weekend when you know you're gonna be home and you can have the support of your partner or a support person there with you while you're going through the process of the bleeding and the cramping and the pain and the things that have to go through that. And then, of course, the last option being a surgical procedure, which, you know, I was able to offer. And for some people, they prefer to just, they don't wanna think about the fact that they're still carrying this pregnancy inside of them that's not gonna survive. That doesn't, that's, that's passed.So because of it, they'd rather just have the procedure in order to have closure. Have closure in a sense. Be able to move on in a sense.

Whereas for others, they really wanna be able to experience the natural process. And at the end of the day, in both scenarios, you're still grieving. So she did choose to have a surgical procedure and I saw her-

Touseef Mirza:
Can you explain what the surgical procedure is?

Dr.Sophia:
I can explain what the surgical procedure is. At eight weeks, we typically do something called a dilation and curettage with suction. And usually, we use a cannula that's less like, I don't know what to, how to say abrasive. Maybe we use an instrument that's going to be less traumatic to the uterus in order to just empty the womb in terms of taking out all the contents of the womb without causing any injury to the womb. And it's quick. It's a very fast and pretty easy procedure to perform. And sometimes it can be a better situation because there's less blood loss.

And then the person themselves doesn't necessarily have to go through like all of the pain and seeing the blood and the things that can happen at the time of the actual passing of a fetus, for example.

Touseef Mirza:
Because it might not happen in one shot.

Dr.Sophia:
It may not happen in one shot. It may be over several hours or even over several days. And so in this case, by doing a surgical procedure, yes, it happens quickly and you're able to, you know, kind of go back to your body almost feeling, I don't wanna say back to normal because it doesn't happen that quickly necessarily, but certainly symptoms of pregnancy are gone. The bleeding, like I said, that can happen during a miscarriage undergoing the natural process of it is lessened. And so all of those things, you know, you take into account and she was able to take into account to know what was gonna be the best thing for her.

So after doing the procedure, she goes, it's the same day procedure, and you go home. And then I had her come back just for a follow up so that we can go over the results of what, you know, we typically would send everything to pathology in order to confirm what was there and that there was no abnormality that could be a problem for her for future pregnancies. And then to just talk about the exam, you know, of course I do. You can do an exam and make sure that they're okay, that they're not having any additional complications, for example, of infection or pain. Because that would not be normal.

Touseef Mirza:
How was she when she came back for that appointment?

Dr.Sophia:
The follow up? So that's actually what brought me here. This is what brought me to this episode. This is why I felt like this was important.

Because when she came for the follow-up, she was tearful, she was upset, she was sad, she was going through grief. And I feel like that is a lost population. You're in a little bit of a catch-22. You know, it's like you were pregnant, but you weren't pregnant enough to tell anybody. Like in her case, she hadn't even told her husband yet that she was pregnant. But yet, the second you get that pregnancy test positive, you just start thinking of all the possibilities. You already connect with the pregnancy. You already, your body is already going through so many changes within that short amount of time that reminds you, that tells you that lets you know that you're pregnant and now you've gone through a loss. You've lost the thing that you were connecting to, you were already connected to in an instant. And I felt like she deserved to be in that moment.

She deserved to be able to grieve. She deserved to be able to put life on pause. But nothing else around her is pausing. The reality is that she is going through a process where you feel alone at the end of the day. You're by yourself going through it. It's so different from when you're like, you know, six months and everybody can see your baby bumps. So they know what they know to expect a baby at the end of nine months. You know, they know that you're pregnant, you go to work and everybody knows that Mrs. So-and-so, oh, Jane is pregnant and you know, they get excited for you and they see the pregnancy glow. Right? And at the end of the day, if a woman who's already advanced in her pregnancy, you know, God forbid, has a loss, but she has a whole community who's gonna be able to grieve that loss with her

Touseef Mirza:
Because they've also connected with that journey.

Dr.Sophia:
Because they've connected with her, with that journey. They've connected with her through that. Because we can see it, right? After a while, you can't hide it anymore that you're pregnant. So when a woman who's had a loss at a further point, it's so traumatic, but she can hopefully lean in to her family, to her community, to her friends. The other thing is, is that you feel like no one else has gone through it because nobody talks about it. You feel like you're by yourself. And that's what made me realize that we needed to talk about it, Touseef.

Touseef Mirza:
Because they're not by themselves.

Dr.Sophia:
Because they're not alone. Because 80% of all losses happen at this time in the early part of pregnancy. The majority of pregnancy losses happen early. So that means there's a whole wide group of women that are going through these traumatic experiences alone. And sometimes it's not like their spouses or their partners are not grieving too, but they don't know. They don't, it's like from one day to the next, they're like, oh my gosh, I can't believe this happened. And they try their best. The men in the room, they try to be supportive and they try to understand, but it wasn't in their body. And it was so early that oftentimes they just don't feel the connection.

Touseef Mirza:
Like, you can just get back on the wheel,

Dr.Sophia:
Get back on the wagon and keep moving, keep going. Right. You know? But for the actual person that it happened to, you know, we need to still give people time, give these women time to go through. They, you know, it's, it's so funny because when I thought about it, I was like, gosh, I can thankfully give her a medical note that says that she really shouldn't go back to work right away. But for some women, that's not an option for them. They just have to turn around and go back to work and go back to life. When they're every other minute, they're remembering what just happened to them. And they're, they want to just cry. And even that they can't do.

Touseef Mirza:
Do they feel that they should get over it? Like, is there a feeling of like, am I overreacting? Because it-

Dr.Sophia:
It's so funny you mention that. So outside of them feeling like, first of all, blame when it happens early, they're like, oh my gosh, it must have been that glass of wine I had before I even realized I was. Was it my fault? How could this have happened? There's something I wasn't doing. There's a vitamin I should have been taking. It's because I drank coffee the morning I came for my appointment. It's because we had sex the night before. Like, every possible thing happens in their brain to make them blame themselves. And so a part of it is, first of all, letting them know you are not to blame. You're not to blame. This would've happened anyway.

The majority of these losses happened because of some type of chromosomal mismatch. Like there was nothing you could have done that would've prevented it. And so, no, you're not overreacting. I'm here to say it. You are not overreacting when you have an early pregnancy loss, it's still a loss. And it's not something you just need to get over though. I think I want women to understand that once they come to terms with what has happened, there is still light at the end of the tunnel, there's still the other getting, you can, you will get over onto the other side of it.

Touseef Mirza:
So it doesn't mean that you've had it once, that you have a greater chance of having that happen in the future?

Dr.Sophia:
Well, what I mean is, we know you can get pregnant.

Touseef Mirza:
True case in point.

Dr.Sophia:
We know that you can get pregnant. The other thing that's on the other side is now knowing in your body how it's gonna feel to be pregnant, what are some of the signs and the symptoms? And for me, going through this particular journey with this particular patient, it really hit home for me that when we tell patients, oh, maybe you should wait until after three months to let everyone know that you're pregnant. And that's, there's a really, there's a reason for it. It's because the risk of having a miscarriage decreases by so significantly from, you know, 20% or 25% to like 2% if you've gotten past, you know, the 13 week mark. Because you don't wanna necessarily put everybody, you know, through a rollercoaster per se. However, it also made me realize that you still need to have some support in case this does happen to you. And we need to have better relationships with the people who are close to us so that we feel comfortable saying, I really need to talk to you because something happened.

Touseef Mirza:
You know, it's very interesting what you're saying, and it's so true considering that the highest amount of miscarriages happens-

Dr.Sophia:
Early.

Touseef Mirza:
Early, but that is the exact time when we say don't say it to anybody for other reasons. But still, that is the consequence of the situation that we're talking about.

Dr.Sophia:
That's correct.

Touseef Mirza:
Then maybe another way to look at this is when you think that you are pregnant to at least tell to some people that are the closest to you, even if it might mean that it will be a-

Dr.Sophia:
That we don't know.

Touseef Mirza:
That we don't know. But that is the whole point, is the fact we want people to be on our journey because we want to have that support. Yeah. So it's maybe not, you know, saying

Dr.Sophia:
It's not the, it's not the announcement. It's not necessarily the announcement, but it's to know who are the people who are gonna be able to not just be excited for you, but also be there for you in the event that you do have a loss and it's your partner. Maybe it's your sister or your mom or your grandmother or your friend, your best friend. Also, we don't talk about it so much that we don't realize that if we look to our left or we look to our right, one of those women has probably had a miscarriage. And that becomes the first time that they're able to say, oh my gosh, I'm so sorry you're going through this. I remember when I went through it, you know, it's the first time that you may, you may tell your mom, and that's the first time that she says to you that, oh, I had a miscarriage between you and your brother.

Touseef Mirza:
I think also that what women might be caring when that happens is shame.

Dr.Sophia:
Not just shame, but also the blame. That's the-

Touseef Mirza:
Yeah. But the shame of-

Dr.Sophia:
That, they couldn't do it somehow.

Touseef Mirza:
Yeah. Like there, there's something wrong with listening with, especially the women, you know, there's some women that, you know, don't wanna have kids, or they're okay if they wanna have kids or don't wanna have kids. And some women, like they-

Dr.Sophia:
That maternal instinct is so strong,

Touseef Mirza:
Like that is such a huge purpose for them in this world.

Dr.Sophia:
Is to become mothers.

Touseef Mirza:
Is to become mothers. I'm not a mom. I'm a fabulous aunt though. I love being an aunt. I'm not a mother, but I know some of my friends that, you know, always really wanted to have child. And that is so part of how they want to be on this planet. And so, for that to not happen in that situation where also nobody knows about it, it's almost like your dirty secret.

Dr.Sophia:
It really is. And I, you know, I can even speak just in terms of experience. I've never had a miscarriage, but I've had what's called a threatened abortion. What does that mean? It means that it looks like I'm gonna have a miscarriage and have to sit with that fear. I'll give you a little, just a tidbit, my own little story, please. My first pregnancy, I had absolutely no idea that I was pregnant. I thought I was having a ruptured ovarian cyst, something that I'd had two years prior. And so I went into my doctor saying, I think I have a ruptured ovarian cyst.

Touseef Mirza:
This is with your first pregnancy?

Dr.Sophia:
First pregnancy, first pregnancy. And, this-

Touseef Mirza:
Is before she was an obgyn.

Dr.Sophia:
And this is definitely before I became an obgyn. Okay. But all a part of the journey. I thought I was having a completely different situation, especially since I thought I was getting my period, I was having some bleeding, but I was also having this intense pain or cramping that I didn't understand because I hadn't had it before. Or the only time that I had had a pain that felt so intense was when I'd had this thing called a ruptured ovarian cyst. So I go to the doctor and the doctor comes back in and says, well, I have some good news and I have some bad news. And I said, okay, well, let's start with the good news. And he says, you're pregnant. And I said, that's the good news? Because I wasn't expecting it. It came from nowhere.

Touseef Mirza:
You didn't even know you were pregnant?

Dr.Sophia:
Had no idea, had absolutely no idea. Totally came from nowhere when he said that to me., I was in complete shock when he told me that I was pregnant. And 15 seconds later I say, okay, well, well then what's the bad news? And he says it looks like you're having a miscarriage.

Touseef Mirza:
So from ridiculous up to down all that. And like, how much time?

Dr.Sophia:
30 seconds.

Touseef Mirza:
Like your whole world is turned twice in 30 seconds.

Dr.Sophia:
That is correct. But it's more so the concept for me at that moment, I was like, wait a minute, wait, what? What did you say? Wait, I'm pregnant, but wait, I'm having a miscarriage. And in the moment that he said I was pregnant, although I had anxiety, I had all kinds of things, I was like, what? How can I be pregnant? I started thinking, oh, is this even possible? And then wait a minute, I'm pregnant. And then it hit me like a ton of bricks and I could be having a miscarriage. And for this pregnancy that I didn't even know I had, I already felt a zing, a feeling, a connection. And the concept that I could be losing it was overwhelming. So overwhelming that I was like, well, how did this happen to me? And why didn't I know? And why, why, why is all I kept thinking?

And then the blame came and the shame, as you're just saying happened. But the one thing that was so, I was so fortunate for in that moment as well, is the relationship that I had with my own mother. She was the first phone call that I made because the doctor then said to me, you're gonna have to go to the hospital and, you know, you have to be examined and checked out in the hospital. I called her right away and I said, Mom, I'm the doctor who just told me that I'm pregnant, and they also said that I'm having a miscarriage. And she was just so comforting in that moment, like, it's gonna be okay. Let's find out what's really happening. Grounding, definitely. I'm coming. That was the other thing that she said was that, and I'm coming, I'm gonna be there with you. And just the sheer thought of knowing that she was going to be there to just be by my side was comfort. And so I just, I hold space for my particular patient and for all of the patients and all of the women who have to go through that moment and that feeling by themselves.

Touseef Mirza:
I think it's amazing that we're talking about this because of what we're saying, that we just, that part, we keep it to ourselves. So hopefully, if we're talking about it and if we're recognizing that actually we shouldn't be keeping it to ourselves, even if that means that other people might have a harder journey supporting us through it. But that's what friends are for and that's what family is for. And that's why you are with the people that you want to lean on.

Dr.Sophia:
I agree. I agree. And I feel like even in just friend groups and you know, women's circles, that it's just something we should, I don't wanna call it just normalizing, but the conversation should be normal.

Touseef Mirza:
And this is not to say that this is an easy thing to do. This requires a lot of vulnerability. It requires a lot of trust with the other person, and it's a difficult thing to convey, especially whenever there's emotion of shame involved. So we're not saying at all, yeah, just, you know, talk to your, your friends and family about it, but it's to just open up that path that is a way that we can maybe start to lean into and communicate. And maybe one way is to actually, first of all, to acknowledge to ourselves that there is nothing to be shameful about, that we didn't do anything wrong. So I think maybe that's the first-

Dr.Sophia:
That is the first part.
Touseef Mirza:
That is the first part. Our bodies are our bodies and it's-

Dr.Sophia:
And our bodies actually are made to protect us.

Touseef Mirza:
Exactly.

Dr.Sophia:
And it's why the majority of pregnancy loss happens so early. It's why the majority of them, it's due to things that wouldn't have been compatible with life in the first place, and that our bodies are made so that way we can survive as a species when we are pregnant and when we are going through the labor process and we talk about having a team, a support, you know, like having the people who are gonna be there for you. It's knowing even before you get pregnant, thinking perhaps if I got pregnant, who would, who would wanna know who would be there with me? Who would be there to go through the journey with me? And sometimes having more connection before in the planning phase. And granted a lot of us don't ever plan for pregnancy. I certainly hadn't planned for my first pregnancy. I had no idea, but at least I had the relationship already in place with my own mother that I could make that call.

That in that moment I did not have to feel alone, or at least in that moment, I could lean in on someone who I felt could support me no matter what I had to say on the other end of that phone call. And I want us to always be able to identify those people who are closest to us. And, for some it's, it's gonna be their partners and that's perfectly okay because at the end of the day, they're going through the grief also. Right? Like, I don't wanna not acknowledge the partners in this process, but again, as I speak to the, you know, the women of the group and, and, and the women who are their bodies are going through it and that kind of a connection, just always identify and know who in your circle is for you and is always gonna be by your side, and that you can always confide in. I think it's important that we learn how to build those types of relationships so that way we don't have to go through things alone.

Touseef Mirza:
And we're the only ones that can do that.

Dr.Sophia:
And we are the only ones who can do it. You're absolutely right. Yeah.

Touseef Mirza:
So through all the women who might have gone through this, we send you sincerely our love and our support, because like Dr. Sophia said, we know that it is difficult and there is nothing for you to be ashamed about. And we just hope that this enables you to just feel a little bit more-

Dr.Sophia:
Cared for.

Touseef Mirza:
Cared for, but also maybe relaxed a little bit. You know, I think with the shame also, there's just, you feel tense, tense. There's a tenseness that happens that we are just so used to carrying. So I just want this to sort of just to, maybe it's just to exhale. I don't know.

Dr.Sophia:
I think it's an exhale. I think it's a, we are here, honestly to hold space for all that grief that you deserve to grieve and go through and live in that space. And with time, your heart can be full. Again, thank you for joining us on the Dr. Sophia obgyn podcast. Until next time, bye

Touseef Mirza:
Bye.

Dr.Sophia:
This is General medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.