Episode 5: Psychological Impacts of Early Pregnancy Loss

TRANSCRIPT

Speakers: 

Host: Olivia Moir

Guest: Dr Jessica Farren

00:00:03 Olivia Moir 

Hello everyone and welcome back to It All Starts Here, a podcast focusing on the communication and education of topics in reproductive science and women's health. I'm your host, Olivia Moir, and we are back here today at the Institute for Women's Health, joined by a very special guest who is going to talk us through her work as a clinician and researcher in the field of obstetrics and gynecology.  

We're going to focus in on an area that she has specialized in, which is that of early pregnancy loss and specifically the psychological impacts of early pregnancy loss. Dr Jessica Farren, welcome to the pod. I'm so happy to have you here today to talk about this with your wealth of experience and background in this field. I mean, you've done so much research on the psychological impacts of early pregnancy loss, which I mean as I've come to know in our previous discussions, is such an in-depth area. 

It's not one diagnosis or one experience. There are so many factors and ranges of emotions involved in this experience, and I'm really looking forward to shedding some light on that today with you.  

So without further ado, why don't you tell us a little bit about where it all started for you? 

00:01:12 Dr Jessica Farren 

That's not actually a question I get asked very often anymore. I think I'm so far in that it doesn't tend to come up, but I I was reflecting on this thinking that I think we had a family friend who was pregnant when I was probably 10 or 11, and I remember just being completely mesmerized by the kind of complexity and randomness of the start of life. And watching Matilda the musical with with my family a couple of weeks ago. And there's a there's a song in it called Miracle. I think it is. And they talk about the fact that. 

00:01:42 Dr Jessica Farren 

Every life is unbelievably unlikely, they say, and the chances of life, almost infinitely small. And I think that actually kind of perfectly encapsulates kind of how random that junction is. When you're thinking about starting a family. 

00:01:55 Dr Jessica Farren 

How your life sort of hinges essentially at this crossroads on a on a, on a moment and and and and the two completely conflicting directions. Your life can go in at that stage. And I did some Embryology at university and that was absolutely fascinating. The sort of rate of change in early pregnancy is really something to behold, like it's just. 

00:02:15 Dr Jessica Farren 

Amazing that we've evolved to have those processes happen and then. 

00:02:21 Dr Jessica Farren 

I suppose I finished medical school and actually was thought I might want to be a surgeon rather than an up. 

00:02:25 Dr Jessica Farren 

Some. 

00:02:26 Dr Jessica Farren 

Guy named that eventually realised I much preferred female patients and there's something about early pregnancy which I think just the pace of it and the need for kind of compassion and empathy and and it's just it's always just. 

00:02:41 Dr Jessica Farren 

Massive privilege treating people at that junction at you know the the the highs and the lows. And I've really sort of, yeah, I just felt it's a massive privilege from day one. 

00:02:51 Olivia Moir 

So well said and so good to learn that as well about your background to get into this topic, I think a good starting point on this might just be really defining what we mean when we say early pregnancy loss. You know, as I said, there just seems to be a whole range of forms that this sort of umbrella. 

00:03:11 Olivia Moir 

Term can take so yeah, I would just love to hear your definition. 

00:03:15 

Yeah. 

00:03:16 Dr Jessica Farren 

It's the two main forms of early pregnancy loss are miscarriage and ectopic pregnancy. Miscarriage isn't much more common than ectopic pregnancy and effects up to one in four pregnancies overall. About one out one out of every two women will go through a miscarriage in their life, and it's defined as a loss before 24 weeks of pregnancy. 

00:03:36 Dr Jessica Farren 

Before the stage where we currently believe that that pregnancies are capable of surviving by themselves and they obviously there are some examples of pregnancy surviving a bit before that, but we still keep the definition at 24 weeks. That said, the vast majority are in the very early stages. The first few weeks of pregnancy. 

00:03:53 Dr Jessica Farren 

And and the majority of miscarriages are caused by sort of random genetic abnormalities in the pregnancy. So it's the body's way of recognising that it's a pregnancy that can't form a healthy baby. It often presents with bleeding and pain, and they're the common things that people associate with symptoms of miscarriage. But occasionally people get all the way to their first scan, which in the UK is between 11 and 14 weeks without any symptoms. 

00:04:14 Dr Jessica Farren 

And it's at that point that they discover that the pregnancy hasn't developed. 

00:04:16 

No. 

00:04:18 Dr Jessica Farren 

There'll be a group of people as well, who sadly have to go through the heartbreak of having to make an active choice to to, to terminate a pregnancy from fetal abnormalities and and other people who need to make a difficult choice because of other reasons, even in a healthy pregnancy and and then ectopic pregnancy, which, as I said, is less common than miscarriage but still affects one in 100. 

00:04:37 Dr Jessica Farren 

Pregnancy. 

00:04:39 Dr Jessica Farren 

And an ectopic pregnancy is where the pregnancy, rather than developing in the right place in the lining of the womb, develops outside the womb or outside the normal place in the womb. And the most common type is a tubal ectopic pregnancy, where it's developing in the fallopian tube, which is the part of the of the womb that the egg is transported down and where it's fertilized by the sperm. 

00:05:00 Dr Jessica Farren 

And if it gets stuck there, then there's no space for it to grow. And if it does grow, then it can cause internal bleeding and people can get quite unwell. And that said, a large proportions of over 1/3 of ectopic pregnancies just resolve of their own accord. They recognise that they're not in a place that is welcoming and has space for them, and so they just sort themselves. 

00:05:17 Dr Jessica Farren 

Out, but a proportion of people end up needing to have surgery, and that surgery often involves removal of that fallopian tube. 

00:05:25 Olivia Moir 

I mean, you're so knowledgeable, it's insane how you just have that stored and ready. 

00:05:29 Olivia Moir 

To. 

00:05:29 Olivia Moir 

Every day. But it's, I think, just something that you said as well. Just the beginning is really just for me. And I think so many people just really recognizing how common this is. And I mean, as we'll talk about today, just the concept of how it's like, not talked about or how it's not educated on and. 

00:05:49 Olivia Moir 

In school systems, even just from a young age, I think it can make such a difference to just know. 

00:05:54 Olivia Moir 

Like with that phrase of it's just a normal part of the women's life course, like these things are that. 

00:06:00 Olivia Moir 

Common. 

00:06:00 Dr Jessica Farren 

Not to dismiss it, not to make it sound like you know, just just because it happens commonly to people doesn't mean it's not horrible. Just breathing happen. Yeah, everyone has to lose their parents or, you know, horrible things happen. But it is. But. But I think the most important message from that is that women need not to blame themselves when it has happened, but. 

00:06:15 Dr Jessica Farren 

I mean 250,000 miscarriages a year in the UK, so. 

00:06:18 Dr Jessica Farren 

An app it's a mammoth. When you start looking at how, even if it's just a small proportion of people who might be affected in a certain way, it actually becomes a massive public health issue because and those are people who are at the prime of their lives, right? They're all working or have family or, you know, they're they're really needed in society. And when these things throw them off balance, it's it's a big deal. 

00:06:24 Olivia Moir 

M. 

00:06:38 Olivia Moir 

Yes. 

00:06:38 Olivia Moir 

Yeah, definitely. 

00:06:41 Olivia Moir 

That's really helpful. Thank you. So I guess just part and parcel with that is the fact that as well as all of these different ranges of what early pregnancy loss can look like, there's also as you alluded to just a range of psychological impacts that can come with it. So would just love to hear more on that from you. 

00:07:01 Dr Jessica Farren 

Yes. So this was actually the subject of my PhD. So a few years ago now, but I embarked on a project to look. 

00:07:06 Dr Jessica Farren 

At the emotional impact of pregnancy loss and and I'll talk a little bit about some data. But I think broadly there's there's some sort of divide the pregnancy loss experience into some sort of subtitles that describe how a lot of people feel it. And I think one of the most important emotions, which hasn't really been recognized. 

00:07:28 Dr Jessica Farren 

Until recent years. But is that of grief and so experiencing it as a bereavement, as you would at any other time of life. You know, you make that connection with an early pregnancy and you start imagining what your life is going to look like with that person. And then that snatched away from you. 

00:07:42 Dr Jessica Farren 

And and I think you know, I think what what's often really interesting talking to my patients is they often talk about the fact that they're mums or older generations don't really have that much sympathy for what they're going through. There's this kind of sense of well, in my day, you wouldn't have even known that you were pregnant by now type thing. But I think there's clearly been some massive medical. 

00:08:02 Dr Jessica Farren 

And sort of social advancements in the. 

00:08:04 Dr Jessica Farren 

Last few years. 

00:08:05 Dr Jessica Farren 

So, you know, pregnancy tests have got massively more sensitive and more readily available early pregnancy units where you scanned the early pregnancy using transvaginal scans only arose in the mid 1990s and and obviously seeing that embryo on the screen with a heartbeat has a massively kind of humanizing bonding effect when you're watching it. 

00:08:17 

Hmm. 

00:08:25 Dr Jessica Farren 

And and then there's also, you know, like social media, where people are forever posting these tiny pictures of an embryo and they're, you know, amongst the blank, the crocheted blankets and the dummy. 

00:08:36 Dr Jessica Farren 

Me and then, you know, we can't make wait to meet you on a on a little board. I think all of it has a massively humanising effect. So I think I think people do very quickly bond with the pregnancy and I think therefore grief is actually you know needs to be recognized. 

00:08:53 Dr Jessica Farren 

As as as as. 

00:08:55 Dr Jessica Farren 

Significant emotion and and the sorts of things that help people manage grief. So I have a friend, Zoe Clark Coates, who runs saying goodbye. And they did these amazing things where there are services around the around the world around the. 

00:09:06 Dr Jessica Farren 

World where people get to go and recognize their loss because one of the issues with early pregnancy losses, people refer to it as a sort of disenfranchised grief where there aren't kind of standard rituals for people to go through to help them sort of process. And there's not kind of standard thing. There's not cards that you send people, you know, you know whether to send flowers or whether not to talk about it. So. 

00:09:27 Dr Jessica Farren 

Yeah, the grief is it's definitely grief, but it's a slightly more complicated grief that society doesn't really know how to handle. 

00:09:34 Dr Jessica Farren 

And then there's the. Then there's the trauma, and that's the one thing that my research was really one of the really interesting findings of my research, because the physical experience of loss can be really intense. And even if it's not that experience of having been responsible for a life and having lost that is also massive. Can that can be massively traumatic. 

00:09:55 Dr Jessica Farren 

But you know, for a lot of women, it's the first time I've ever had to go to hospital. The first time we've ever had to have IV access, some of them end up having a blood transfusion. Some of them end up being put to sleep under general anesthetic. In an emergency, they wake the people who come in sort of an extremist with an ectopic pregnancy. Thankfully, very rare. But sometimes they get rushed into hospital, you know, barely conscious and wake up. 

00:10:15 Dr Jessica Farren 

With the concept that they had this operation, which is removed part of their reproductive organs, and it's, I think the whole thing just has scope to be hugely traumatic. 

00:10:23 Dr Jessica Farren 

And and my research. So we refused to stay over 1000 participants and we found that actually crazily at the one month mark, about 1/3 of women were reporting symptoms consistent with post traumatic stress. 

00:10:37 Dr Jessica Farren 

And that only dropped to about 1/5 of women at the nine month mark. So these are symptoms that really persist and the the experience as pregnancy loss really stay with women. And what you'll find talking to women who've been through loss is that often the kind of that they'll get flashbacks of a physical experience for a long. 

00:10:53 Dr Jessica Farren 

Long time afterwards. 

00:10:56 Dr Jessica Farren 

So that's. Yeah. So grief and trauma. There's a lot of concern for the future. That's very natural when this happens. And we looked at anxiety as a quite a prevalent response again to about 1/5 of women experiencing quite severe anxiety because people often go through through life. 

00:11:15 Dr Jessica Farren 

Kind of. Thankfully not knowing all the all the things that can happen when you start wanting. Just assuming that when they want to start a family, it's gonna be straightforward. Plain sailing, especially people who haven't. You know, I always think it's helpful if you've got a sister or a cousin who's been through some difficulties, you at least know it's a possibility, but a lot of people get that junction. They just have no idea it might ever be an issue. 

00:11:35 Dr Jessica Farren 

And then as soon as it is, they suddenly completely panic. That actually the idea of having a family is just not, you know, my is not a given. 

00:11:45 Dr Jessica Farren 

And that's really, really hard. And and then of course, you know a number. 

00:11:49 Dr Jessica Farren 

Of the women I. 

00:11:49 Dr Jessica Farren 

Meet who have who have finally got pregnant after many years of sub fertility or IVF. And then they have a miscarriage. I mean, that's a whole nother, a whole another experience, which is just impossible to get through. And so there's that. The other thing that I think. 

00:12:05 Dr Jessica Farren 

Is a really common reaction which I do my best to sort of negate when I'm speaking to women is about around self blame. 

00:12:12 Dr Jessica Farren 

So. 

00:12:15 Dr Jessica Farren 

We talk quite a lot about how the language we use in pregnancy loss, where we don't notice it anymore when we're using it, because it just sort of rolls off the tongue. But even the word, miscarriage, miscarriage, it implies this responsibility for the carriage of the baby that you've not done well enough, missed miscarriage. You didn't even notice that you weren't very good at carrying the pregnancy. 

00:12:34 Dr Jessica Farren 

Incompetent cervix. You know it all sounds like there's blame at the at the door. 

00:12:39 Dr Jessica Farren 

Of the of the woman. 

00:12:40 Dr Jessica Farren 

And you, you also look at like how society tells us to behave in pregnancy and you type into Google like things not to do in pregnancy and you'll get a list as long as your arm in terms of all the feeds. You've got to avoid all the activities you've got to avoid. And so it's very natural when you then go through a pregnancy loss to you envisage that there are things that you could have done differently to prevent it. 

00:13:01 Dr Jessica Farren 

And so I think this message that there isn't and that the vast majority are issues with the pregnancy and there's a small proportion we don't know. But there's really after years and years of trying to research this, there is such tenuous evidence that anything has anything to do with what. 

00:13:15 Dr Jessica Farren 

The woman does. 

00:13:16 

MHM. 

00:13:17 Dr Jessica Farren 

That it's like it's never the women's fault or anyone's fault. It's just, yeah, rubbish. And then the other reaction, which I think it's really important to air is that of relief. I think there are a huge proportion of people who didn't plan and didn't want the pregnancy, you know, one in four pregnancies in the UK and in termination. 

00:13:36 Dr Jessica Farren 

And and, but I think what's really important is to recognise that people can feel relief alongside the other emotions. So it's very common to feel relief that this pregnancy isn't progressing while being worried about the fact that in the future you might be more likely to have a miscarriage. And I think it's actually really problematic when people assume that just because the pregnancy wasn't wanted that you don't, you aren't allowed to feel the rest of the emotions, cause you might also feel grief. 

00:13:59 Dr Jessica Farren 

And. 

00:14:00 Dr Jessica Farren 

And sadness and concern for the future. So it's I think you know, everyone has a right to feel all the emotions and I think everyone feels all of the emotions to sort of different degrees and it depends what the background is and how they've got to that place as to which of the and what their sort of physical experience was as to what the predominant experience. 

00:14:17 Dr Jessica Farren 

Was. 

00:14:17 Olivia Moir 

Definitely. Yeah. I mean, you said it so well. That was sort of where I was going with it too, is just like, I mean the feelings that people have. 

00:14:26 Olivia Moir 

Can be such a range, you know on top of all the different psychological impacts, and I mean something really powerful that you said to me before. This is just this concept that people can feel, you know, it's not mutually exclusive. You can feel one way you can feel another way you can feel, you know, as you said, relief or you can feel extreme sadness. 

00:14:46 Olivia Moir 

It's, you know, it's OK to feel. However you are. And then I think as well as something that like I've been exploring in my personal life is just this sort of like. 

00:14:57 Olivia Moir 

Concept of your feelings about your feelings. So your perceptions of the feelings that you're having and and the impact that that can have on you as well. On top of it. So just sort of like getting your perspective on you know how we can do better. 

00:15:13 Olivia Moir 

In in general, I think to communicate when someone is going through this experience. 

00:15:20 Dr Jessica Farren 

Yeah, I think this is. This is the really tough ask because I think what's been really interesting in recent years is that, I mean, I hope my research has played a small part in this, but there's been increasing narrative on the experience of pregnancy loss and how upsetting and traumatic it can be. 

00:15:36 Dr Jessica Farren 

Which I'm obviously massively in favor of, and I think it's a wonderful move, but it it has really been. 

00:15:43 Dr Jessica Farren 

On my mind lately that there is a risk that the pendulum has swung too far and that actually there were a group of women for whom the experience wasn't of the loss of a baby. It was of something, you know, a lot of women go through, early miscarriages where the physical experience is not intense. What they've seen on the screen, if they've even had an ultrasound scan. 

00:16:03 Dr Jessica Farren 

Is an empty gestation sack without. 

00:16:04 Dr Jessica Farren 

Any recognizable baby and they have a miscarriage at home. Natural thing to do is just to flush the loo and it, you know, and and and actually I I sometimes reflect and worry that with so much emphasis on a certain way of feeling after pregnancy loss and how you that the expectation is that you. 

00:16:24 Dr Jessica Farren 

Might feel grief that then you're making a group of women who don't feel like grief, even when it was a desperately wanted pregnancy, who process it in a different way, who deal with it as a kind of medical event. 

00:16:36 Dr Jessica Farren 

There's a risk that you might alienate those people, so I think and and and and this comes up in loads of different ways in what we do. So in terms of we've got some guidance out there, which tells stenographers how to talk about the loss as they diagnose it. And that's particularly targeted to the later scans where it's a complete surprise. But there is guidance there that tells us that we have to refer to it as a baby. 

00:16:58 Dr Jessica Farren 

And of course, in my experience in early pregnancy, that often really feels like the wrong thing to do, it feels really jarring for a group of women who were just dealing with it in a different way, not a wrong way, not a heartless way, just in a different way. 

00:17:09 Dr Jessica Farren 

And and similarly we have a situation where, as I say, if you pass the pregnancy tissue at home, often naturally will just be it will happen in the toilet and you and you might not think twice about it, but other people will be really important that pregnancy tissue has that, that it that it's handled in a way that's sensitive. And certainly if you pass that tissue or you bring that tissue into hospital. 

00:17:30 Dr Jessica Farren 

And we have a responsibility to to the patient to discuss the options as to how they want. 

00:17:36 Dr Jessica Farren 

Handled and it's a real minefield because actually for a lot of women, asking them to feel something towards what essentially looks like a looks like a blood clot or look like on a screen, like something unrecognizable kind of makes them feel worse. It kind of makes it take on a a like. 

00:17:56 Dr Jessica Farren 

Something that they just hadn't seen. 

00:17:59 Dr Jessica Farren 

Being and then the worst part of that would be if it then made them feel like they were less worthy of being a mother or like kind of less motherly in terms of how they felt. Because yeah, I think I just don't think you can be prescriptive about how people are going to feel. And I think the real challenge, whether you're a medical professional or whether you're someone dealing with a colleague or a friend going through this, is to try and pitch how you are with that person. 

00:17:59 

MHM. 

00:18:20 Dr Jessica Farren 

Kind of what they need and how they see it. So we need to have options if people are feeling grief, then it's great that you know. 

00:18:28 Dr Jessica Farren 

That. 

00:18:29 Dr Jessica Farren 

Charities exist where that can really be recognized. 

00:18:32 Dr Jessica Farren 

But on the flip side, we also need to make people feel that if they don't feel like that and they just want to move on straight away, you know, I get to the point where I worry that some of my patients feel bad asking about when they can try again because it implies that they don't care about. 

00:18:44 Dr Jessica Farren 

Their current loss, which is bananas, because actually. 

00:18:47 Dr Jessica Farren 

Of course, they're gonna want to. Of course. You know the I think the the for a lot of people the quickest way to heal is is on to a next the another pregnancy. 

00:18:48 Olivia Moir 

Yeah. 

00:18:57 Olivia Moir 

Yeah. And and just. 

00:18:59 Olivia Moir 

You know, reinforcing the idea that there's no judgment or criticism whatsoever, it's just something that has happened and you know, you have every right to take your way forward and it it should be based exactly on what you want to do. Yeah, and not on anything else kind of externally. So on that note of management. 

00:19:04 Dr Jessica Farren 

Yeah. 

00:19:06 Dr Jessica Farren 

Yeah. 

00:19:14 

Yeah. 

00:19:19 Olivia Moir 

Of this, in a clinical setting, I mean, we'll talk about kind of outside of clinical after. 

00:19:24 Olivia Moir 

But you know, as you said, it's such a minefield for physicians and and just also everyone in the hospital setting when it comes to this. And I I would love to hear you know your thoughts on, you know how can we do about this and and? 

00:19:39 Olivia Moir 

What? 

00:19:39 Olivia Moir 

Are some key challenges. I mean, you've already sort of touched on when it comes to this. 

00:19:45 Dr Jessica Farren 

Yes, I think you know the language is super important and in terms of sort of like reflecting what is seems appropriate, how how the person has referred to it themselves or sees it themselves and trying to pick. 

00:19:58 Dr Jessica Farren 

Up on those keys. 

00:19:59 Dr Jessica Farren 

I mean, I think the other thing that we need to do a lot better in is in terms of allowing people to take the time off work that they need so. 

00:20:06 

MHM. 

00:20:09 Dr Jessica Farren 

I think up until now, society is generally brushed under the carpet and I think that's partly because, as a woman's health issue, everyone gets just embarrassed talking about it. Anything that might involve bleeding and never mind vaginal bleeding is just is is something that people aren't prepared to talk about. 

00:20:23 Dr Jessica Farren 

Work. But also I think we had a massive issue which people don't like acknowledging, but is definitely there with early pregnancy loss. Is that to tell someone at work you're having a miscarriage as also to tell them that you're trying for a baby, which then people worry about? Understandably, it's going to have an implication on sort of their position in the company on promotions. 

00:20:43 Dr Jessica Farren 

Because people assume that in the not too distant future, they're going to have other priorities and be taking an extended period of leave. Yeah, it's really complicated. I mean, I think we need to, we need to. 

00:20:52 Dr Jessica Farren 

Move forwards in terms of opening the conversation and being it, but I completely appreciate that for some women it career wise it's not the right thing to do and they really don't want to share that. So as much as I kind of stridently believe that we should be proud about talking about Women's Health issues is the one area where I can understand there needs to be some sensitivity, but the other point of progress. 

00:21:00 

MHM. 

00:21:10 

Yeah. 

00:21:13 Dr Jessica Farren 

At the moment is in terms of pregnancy loss leave, which is pretty exciting. So the miscarriage association led by Vicky Robinson has done a fantastic campaign with Sarah and one of their MP's who's head of the Women's and Equalities Committee, and they've been working on statutory improvement leave after Miss. 

00:21:30 Dr Jessica Farren 

Marriage, rather than having to use sick leave as the only vehicle to get time off after a miscarriage. So I think that will. So it's sort of progressing at the moment and it's I think the plan is for it to be incorporated into the employments rights, employment rights bill in the not too distant future, which is a really exciting step because I think it's a vehicle to. 

00:21:50 Dr Jessica Farren 

Said. 

00:21:51 Dr Jessica Farren 

To sort of open the conversation more widely about the need for people to process something that is a big life event, because whatever your reaction to it is, it's still like absolutely stops you in your tracks. 

00:22:04 Olivia Moir 

Yeah, definitely. It's so interesting. And it's, I mean, it's just it's great news to hear that. It's being acknowledged in Parliament and in other contexts as well. So I'll look forward to hearing sort of the updates on that. 

00:22:19 Olivia Moir 

Another thing that when it comes to the workplace that you're doing, which I just think is amazing, is this is womanhood. So tell us about that. I know that our listeners would just be so keen to hear about it. 

00:22:34 Dr Jessica Farren 

Yeah. So this is womanhood is a organization, I suppose, which I started with two friends. 

00:22:41 Dr Jessica Farren 

And Amy Linda's, an old colleague from from many years ago, and it basically started from this concept that for many years now I have found that if I go to any wedding or Christmas party, there's often a little queue of people waiting to talk to me about various gynecological issues. So for many years, I can tell that I'm getting older as well because for many years. 

00:23:02 Dr Jessica Farren 

Was was, was pregnancy related or fertility related? And now I'm moving on to many more. 

00:23:07 Dr Jessica Farren 

Questions about the metaphor force. 

00:23:09 Dr Jessica Farren 

But I think what has occurred to me over the years is how much I have appreciated coming at my own pregnancy and pregnancy loss. 

00:23:16 Dr Jessica Farren 

Bernie, with this, put a specialist inside and knowledge and or you know, a host of people to call for advice along the way and how much? 

00:23:26 Dr Jessica Farren 

I have been needed by sort of close family and friends who felt that they could call me sort of even like calling me in the middle of the night, going through these things. 

00:23:32 

MHM. 

00:23:37 Dr Jessica Farren 

But this sense that there's a real gap there with people, with schools not providing adequate information and education about Women's Health issues, and people often like really motivated, highly educated, well read people. 

00:23:51 Dr Jessica Farren 

Really just not getting the information that they need because the problem with all social media at the moment is you get it's very targeted. So if you're interested in one thing you might. So if you're interested in pregnancy loss, you'll probably read a lot about pregnancy loss, but you'll miss out the whole rest of women's reproductive journey and. And so we felt there was a real gap there to providing people with. 

00:24:10 Dr Jessica Farren 

A sort of whole life stage approach to all the gynecological issues that you might might come across so that they would have the information. 

00:24:19 Dr Jessica Farren 

To recognise where there were problems and know where to go for help so you can't go into stuff in matters of detail, but just an acknowledgement of all the different things that life throws at women. And so we've done this lecture, we've titled it 10 Things you'd know if your best friend was a gynecologist. 

00:24:35 Dr Jessica Farren 

And and we've been going into predominantly law firms, banks and doing lectures. 

00:24:43 Dr Jessica Farren 

Just going through a very whistle stop hour of all the things that are really useful for you to know as a woman yourself or as a mother, sister, husband, work, colleague, partner. You know the whole shebang. Just to give you an understanding of the types of things that are problems and that you can get help for and that it's OK not to just live with because so much of Women's Health. 

00:25:05 Dr Jessica Farren 

Is just, you know. 

00:25:05 Dr Jessica Farren 

Get is the same way you grew up at age 11, everyone in the UK age 11, I think even still now used to get a little packet of sanitary towels from always at school and E to say that your period might be heavy or painful. And I think women really internalize this stuff and they just assume that it's a women's lot to deal with this ship, like all the way through their. 

00:25:25 Dr Jessica Farren 

Lives and you meet people who have been dealing with things for sort of 20 years and just thought that they didn't have reason to complain about it. And and I think, you know, it definitely comes out with miscarriage as well, where people just, you know. 

00:25:26 Olivia Moir 

Yeah. 

00:25:37 Dr Jessica Farren 

They it, it's just it's a women women's business women's and it's and it and it and and the cost of it has been that it's not been a priority to for research for all these years and actually that's one of the really exciting things about this is womanhood which we need to do much more of but and the the people who we've given lectures to in lieu of any payment for the for the lecture we actually get donations. 

00:25:57 Dr Jessica Farren 

Into the CLH charity which we've been able to use already to to do some research. So we've been we've been doing a research project looking at the psychological impact of cesarean section scar ectopic pregnancies, which is a kind of less common form of ectopic pregnancies. But it's really exciting to see it kind. 

00:26:14 Dr Jessica Farren 

To then promote future Women's Health research as well. 

00:26:17 Olivia Moir 

It's amazing. I mean, honestly, it's so fantastic. And I just like if I could have a megaphone to the rest of the world to say that this is happening, I would. I mean, I just know that there are so many people backing this whole concept of especially coming into these sort of, you know, work places where you wouldn't necessarily expect to have these. I mean, I don't think anyone expects those conversations in a work. 

00:26:39 Olivia Moir 

But particularly a law firm or a bank, I think it's just sort of breaking it up and it's like we're all humans and we're all, you know, attached to this in some way. So. 

00:26:48 Dr Jessica Farren 

And you have, you know, you have you sit there for an hour and you have to listen to. You have to listen to in bit about incontinence. You have to listen to the bit about it for a few men at the back squirming. But like it has, you know, you just you have to. 

00:26:58 Dr Jessica Farren 

It's not just the bits that you choose to read about, it's the whole, the whole shebang. 

00:27:01 Olivia Moir 

Yeah. 

00:27:02 Olivia Moir 

No, it's so fantastic. Yeah. I'm so happy that it exists, and I can't wait to see all that you do. So I think in terms of wrapping this up, something that came to mind to me while we were recording this is just. 

00:27:15 Olivia Moir 

It would be good if we could have your thoughts or just a couple of practical tips. You know, as just people listening to this episode. You know, if you know someone or you are someone that has gone through early pregnancy lost or you know, you will inevitably have that experience, perhaps of having a friend, a family member yourself. 

00:27:36 Olivia Moir 

You know what are some tips that you can give to people you know? 

00:27:42 Olivia Moir 

Of sort of helping these people or yourself when you're going through this kind of experience. 

00:27:49 Dr Jessica Farren 

Yeah. I mean, I think again, it really depends on the person and how what their experience of it is like. But I think just being sort of open and being like comfortable talking about it. Yeah, because I think like I remember sort of my own miscarriages, there's a sense of sort of slightly like slight embarrassment about the fact that your bodies let you down and it's not something and you suddenly. 

00:28:09 Dr Jessica Farren 

I I kind of really wanted to be open about it, but there was a part of me that kind of. 

00:28:14 Dr Jessica Farren 

Like was worried that it kind of ridiculously, but, like, reflected badly on me, which is an absurd thing for me to say after everything I've said that you. But I think just breaking that stigma, I think, you know, for the most part giving people a hug, giving them space to be ****** ***, angry, sad, whatever they want to be, you know, chocolate flowers. 

00:28:28 Olivia Moir 

Yeah. 

00:28:34 Dr Jessica Farren 

Any of their stuff, just acknowledging that it's just a really, really rubbish thing for people to go through, yeah. 

00:28:39 Dr Jessica Farren 

And and recognizing that it's going to come with a whole heap of anxiety about the future and and and sort of supporting them through that. I think just just just being comfortable with the fact that it's a horrible thing to go through, I mean and but also being kind to yourself as as in regards to like every time I have to write a card or a with sympathy card, it's actually really hard to find the words. 

00:28:44 Olivia Moir 

Mm-hmm. 

00:29:00 Olivia Moir 

Yeah. 

00:29:00 Dr Jessica Farren 

Like it is tricky to know what to say, and that's OK too, so be gentle with yourself as someone supporting someone going through it because it's hard to know what the right thing to do is, but just just like so much of it is just just being there, being it out and showing up and you know, showing up a couple of months later and checking in and still being OK about talking about it and just just being there. 

00:29:13 Olivia Moir 

Yes, that's showing up. 

00:29:21 Olivia Moir 

So it's so helpful to know. Thank you so much. I think as well just to final finally close it off. I always like to hear a little bit about, you know what you see for the field going forwards. I mean, I think I have some thoughts as to what you're hoping for, but. 

00:29:36 Olivia Moir 

I. 

00:29:36 Olivia Moir 

Would love to just see what you you are hoping for and and what you see for you know the field of early pregnancy loss in the future. 

00:29:45 Dr Jessica Farren 

Yeah, I mean, firstly, I'd love to prevent pregnancy loss. That seems like quite a big ask. Yeah, but I hopefully they'll be more understanding about the the sort of pathogenesis as I say, the big issue with miscarriage is that so much of it is genetic that it seems like that, that, that process is inevitably that it seems very unlikely in my lifetime that we're going to be able to interrupt. 

00:30:06 Dr Jessica Farren 

Process where things go wrong in those early stages. 

00:30:10 Dr Jessica Farren 

But yes, to find out, but especially poor people who experience recurrent miscarriage without genetic abnormalities, there's clearly something about miscarriage that we don't understand and anything to sort of further, that field of research is is right up my street. And and then I guess the other part in line with my research is just to have a better understanding as to how to formally support people after pregnancy. 

00:30:31 Dr Jessica Farren 

Us so there are amazing organizations. 

00:30:36 Dr Jessica Farren 

The Miscarriage association ectopic pregnancy trust and saying goodbye, all of whom work with women and in the aftermath of pregnancy loss and and provide an incredibly important service. But is there? 

00:30:47 Dr Jessica Farren 

A more for. 

00:30:48 Dr Jessica Farren 

For a group of people who need it, is there a better way of supporting them down the line and and what difference would that make? 

00:30:55 Olivia Moir 

Definitely. 

00:30:56 Olivia Moir 

I mean, this has just been so helpful and I've learned so much from you. So thank you so much for coming on. It's been an amazing conversation. 

00:31:04 

Which one?