In the second of a two-part series on miscarriage, Zahra Shahtahmasebi talks to two organisations working to open up the conversation around miscarriage.

Part one: The silence of miscarriage

While midwives and doctors help bring babies into the world, they’re also the first to know when there’s been a miscarriage. For midwife Tawera Trinder and doctor Moerangi Tamati  at Hāpu Wānanga ki Taranaki, that often happens when they check in to confirm attendance for upcoming workshops. 

“They’ll say ‘we actually can’t come any more because we passed baby’,” says Trinder (Te Ātiawa, Taranaki Whānui, Te Ātihaunui a Pāpārangi), adding miscarriage is a really difficult experience for a lot of whānau, especially in a system that is not culturally sensitive to their needs as Māori.

Trinder and Tamati (Taranaki Tuturu, Te Ātiawa, Ngati Mutunga, Ngāi Tahu) have been working together for more than four years at the kaupapa Māori organisation, providing free antenatal workshops grounded in tikanga and matauranga Māori. Trinder is the chief executive, and while Tamati now lives in Auckland, she continues to provide support.

Knowing there were some whānau feeling particularly isolated in their experience, Trinder and Tamati got to wondering what they could do to help them feel more “culturally embraced”.

“So we thought we’d send them a koha,” says Trinder. The care package includes some pamper products, foodie treats as well as a card. 

The card features a karakia composed by writer and broadcaster Scotty Morrison that tells the story of pēpi joining their tipuna in the sky. “And just from that small thing, the responses we’ve had shows that acknowledging the miscarriage goes a long way, when it’s often overlooked and underappreciated,” says Trinder.

Not only does the koha acknowledge the miscarriage itself, but also the missed opportunity for that whānau to attend and learn at Hāpu Wānanga, Tamati adds. Last year, Tamati miscarried her second baby. She knows that her experience was unique – she got through it because of both her medical training and connection with her culture. “There was no Māori support for me but I’m lucky that because I am a doctor, I understand it all and I have tikanga Māori knowledge to be able to heal from it myself.”

In spite of the grief that accompanied her miscarriage, Tamati says that the baby blessed her with “heaps of learnings”.

Her experience has made her more passionate to explore miscarriage from a te ao Māori perspective so she can use that knowledge to better support others. Her vision is to set up a version of Hāpu Wānanga for those who have had a miscarriage. It would be smaller, more like a focus group, but like Hāpu Wānanga, sessions would focus on pre-colonial practices.

“It would be an opportunity for those seeking healing to have that space to talk about pregnancy loss as well as an opportunity to learn and connect with their culture,” says Tamati.

She adds that while Western ideology tends to view a period, a birth and a miscarriage all as separate events, Te ao Māori says all of these exist together on the same spectrum. “For Māori, it all comes from the same place, the uterus. Even if you’re not actively conceiving, the fact that you are having menstrual cycles means you are fertile.”

Teachings from researcher Ngahui Murphy’s thesis looking at pre-colonial menstruation show that all aspects of this spectrum should be considered sacred and treated with respect. “When a baby is born, you deliver the placenta and bury it. The pregnancy tissue from a miscarriage should go into the earth as well, wherever that woman and her whānau deem to be the most important place,” says Tamati.

For her, that was her grandparents’ grave, the same place she buried her first child’s placenta a couple of years earlier. Her own placenta is there, as well as that of her sisters’ and cousins’.

Another act of healing was naming the pregnancy. And a little over a month ago, Tamati gave birth to her second daughter and named her after the baby she lost.

For Aleisha Black and her sister Corrine Christian, setting up their own charity dedicated to miscarriage has been their way of starting conversations on the topic almost always shrouded in silence.

In 2018, Christian had a missed miscarriage, which means her baby stopped developing without her body realising. She went for her 11-week scan, only to discover she had lost her baby three weeks prior.

Together, the sisters scoured the internet for information, wanting to know more about what Christian was going through. Their searching yielded the definition of a miscarriage, but not much else. Compelled to fill the clear gap they had discovered, they created Miscarriage Matters in the small North Canterbury town of Amberley in July 2019.

Black describes Miscarriage Matters as a bridge to connect New Zealanders experiencing miscarriage to a network of support. “We know a lot of organisations, so when people reach out, we can send them resources, we can connect them to services, like a specialist miscarriage massage,” she says.

Their website is their biggest asset, providing information on a range of topics from the physiology of a miscarriage and its symptoms, to how to take care of yourself physically and emotionally. The grief of a miscarriage is isolating – it’s a loss that can pass unseen by others, making it hard to talk about, says Black. She remembers how hard it was for her sister to tell people about her miscarriage because she hadn’t even shared with them she was pregnant. “She questioned: ‘how can I now tell you the bad news, when I didn’t tell you the good news?’”

This leads Black to talk about the Butterfly Fun Run, an event Miscarriage Matters hosts during Baby Loss Awareness Week (9 – 15 October) at The Groynes, a large nature reserve in Christchurch. She says it is the highlight of her sister’s year, because its sole purpose is bringing people together to show them they are not alone. “All kinds of different people are there and by doing something positive together, it makes [miscarriage] easier to talk about.”

Black’s biggest piece of advice to those going through a miscarriage is to keep reaching out for support – “there are so many compassionate people who want to help,” she says.

This is exemplified by the people who support Miscarriage Matters, whether it be donating money at fundraising events, or gifting products for the care packages the charity delivers to women who experience miscarriage in Canterbury, Auckland’s North Shore and Wellington.

In these packs is a keepsake, like a keyring, that women can choose to keep or bury in honour of their baby. There’s a donated pamper or wellness product – most recently, Karen Murrell lipstick – a little treat, like chocolate, a tiny teddy bear from Sands, the Stillbirth and Neonatal Death Charity, as well as two-for-one vouchers for coffee. 

The packages always include a handwritten note, just like Trinder and Tamati’s.

Specific to the Canterbury packages are seed bombs, that, if scattered in the garden, are said to attract butterflies, which is the Miscarriage Matters symbol, says Black. “We came up with that when starting the charity as traditionally, butterflies are thought to be little spirits.”’

Overall, Black says miscarriage is a topic that New Zealand could be much better informed about. A long-term goal of hers is to see increased education in high schools and universities on miscarriage, so more New Zealanders know what this journey looks like.

She calls for New Zealand to follow in the steps of Norway and start collecting data on miscarriages. Norway started recording miscarriages back in 2009, and now has solid data to show prevalence in first time pregnancy. 

Meanwhile in the North Island, Tamati and Trinder are still working on just how exactly they’ll change the world to make people more comfortable talking about miscarriage.

But a lot of it is simple – instead of shying away, don’t be afraid to ask questions and be a listening ear, says Tamati. This provides much needed acknowledgment to prevent whānau feeling isolated in their grief. “Honestly just ask them about it – when was the due date, how do they feel when the due date comes around? What were their hopes for that baby – did they have a name?”

Tamati finds it incredibly healing to talk openly about her own experience: “I’ve been pregnant with three babies, two are living, and I want to talk about that.”