Miscarriage and mental health with Hard to Bear author Isabelle Oderberg

Our guest for this episode is Isabelle Oderberg. Isabelle is a Melbourne-based journalist and author who  joins Get Real to talk about her book Hard to Bear: Investigating the science and silence of miscarriage. It’s an in-depth investigation about miscarriage – the world’s most common pregnancy complication and she brings her own living experience, as well as that of many others to this book.

MORE INFO:

• Early Pregnancy Loss Coalition - https://eplc.au
• Unrecognised and underestimated: the fight to get Australian women proper care after miscarriages (The Guardian, 9 August 2023)
• Understanding miscarriage and pregnancy loss with Prof Dame Lesley Regan and Lucy Bannerman (YouTube)
• Miscarriage Australia 

ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.

If you have been affected by anything discussed in this episode you can contact:
Lifeline on 13 11 14
13 YARN on 13 92 76 (24/7 crisis support for Aboriginal and Torres Strait Islander peoples)

ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.

We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.

Transcript

ermha365 team: 0:01

Get Real is recorded on the unceded lands of the Boonwurrung and Wurundjeri peoples of the Kulin Nation. We acknowledge and pay our respects to their elders, past and present. We also acknowledge that the first peoples of Australia are the first storytellers, the first artists and the first creators of culture, and we celebrate their enduring connections to country, knowledge and stories.

ermha365 team: 0:29

Welcome to Get Real talking mental health and disability brought to you by the team at ermha365.

ermha365 team: 0:35

Join our hosts, emily Webb and Karenza Louis Smith, as we have frank and fearless conversations with special guests about all things mental health and complexity.

ermha365 team: 0:48

We recognise people with lived experience of mental ill health and disability, as well as their families and carers. We recognise their strength, courage and unique perspective as a vital contribution to this podcast so we can learn, grow and achieve better outcomes together.

Isabelle Oderberg: 1:09

So I ended up with a really gnarly anxiety disorder as a result of my pregnancy losses. I would say previous to that I had had what I would describe as manageable, regular Jewish woman anxiety and neuroses and as each pregnancy loss racked up, my ability to believe that things were going to work out just eroded and eroded and eroded, and the anxiety went up and up and up. I wanted to interrogate every position, every conclusion. There is no one size fits all when it comes to grief, miscarriage, intersectional disadvantage, layers of disadvantage, all of those things, and we have to consider a range of different experiences.

Emily Webb: 1:58

Welcome to Get Real talking mental health and disability. I'm Emily Webb, and our guest for this episode is Isabelle Oderberg. Isabelle is a Melbourne based journalist and author whose work appears in publications including the Meanjin, Arts Hub, Beat Magazine, the Age and Sydney Morning Herald, to name just a few. Isy was also HeraldSun' s social media editor, the first role of its kind in Australia then went on to lead News Corp, australia's social media nationally. I actually first met Isy back in 2012 or maybe 2013, when she came to teach journalists at Leader Community Newspapers about how to use Twitter for news leads and how to break news stories. I've never forgotten this training.

Emily Webb: 2:45

Isy joins Get Real to talk about her book Hard to Bear investigating the science and silence of miscarriage. It's an in-depth investigation about miscarriage, the world's most common pregnancy complication, and she brings her own living experience, as well as that of many others, to this book, and before we launch into our conversation, we'll have details in the show notes of support organisations that relate to what we're discussing. Welcome, Isy. We're really, really pleased that you've joined us.

Isabelle Oderberg: 3:15

Thanks so much for having me, and I'm so glad that my training stayed with you that long.

Emily Webb: 3:21

It really did. It's like, to date, the best training I ever had.

Isabelle Oderberg: 3:26

So kind, I'll send you some money for that later.

Emily Webb: 3:30

Now, Isy. Hard to Bear is your first book and I've followed you on Twitter for a long time, where you've shared about the journey of writing Hard to Bear and also about your own experiences with miscarriage and pregnancy and that led you to writing this. Can you tell us a bit about that?

Isabelle Oderberg: 3:48

I'll just start out by saying that I am coming to you from the unseeded land of the Yalukit Willam people in Naarm in Melbourne. Sovereignty was never ceded. So basically, I came back to Australia, having worked overseas in newsrooms, and I had this feeling that I was like I think I'm ready to start a family, and it took me a few years, settled in and then decided I was just going to go ahead and do it. So I started having IUI with a donor which is kind of like medical turkey baster is what I call it. I just had my first unsuccessful attempt when I met the man who was to become my husband who I call affectionately on social media Husbo, which I'll continue to do in this interview and he and I fell in love very quickly. We made the decision we wanted kids, but we were going to wait until he'd finished his masters and there was a whole lot of machinations around it. Anyway, we got pregnant and that was my ended up being my first miscarriage. We waited a couple of cycles and then tried again and had our living son, but he was a twin and we lost his twin very early on in the pregnancy and then we waited until my son was about. I think he was about 18 months old. We got married and then decided it was time for our second, and that's sort of when everything went pear shaped. I had five losses in the space of about 18 months, 20 months, and then I eventually got pregnant with my second living child, a daughter.

Isabelle Oderberg: 5:21

Going through that journey, being a journalist and being fairly public about what was happening to me at the time A lot of my editor friends were saying will you write for me, Will you write a column, Will you do this? And I was very reluctant. I think I wrote only just one column maybe in that period on that topic. And then I kind of needed to see where my journey ended. I needed to know. I couldn't do it when I was in the journey. It had to be in hindsight, when I knew that my journey had come to its end, whatever that end looked like.

Isabelle Oderberg: 5:51

And then, once I had my daughter, I started doing some reading, mainly to answer questions that I had within myself Confusion for myself. And when I started reading I was like, wow, there are a lot of answers, but there are way more questions than answers. And that's when I started to realize that there was a lot here that needed to be said and sort of shown to the light, if you like, and that it wasn't a column, it was, you know, or even a feature article, it was a book, and I mean I could have written a book three times the length of the one that I did, and my book is already very chunky. So you know, that tells you, in terms of depth and the topic, you know, how much really needs to be said.

Emily Webb: 6:33

And you know, with miscarriage it's. I feel like it's really sad when you hear that someone's had a miscarriage, but it often gets oh well, that's the body's way, it wasn't meant to be. It kind of doesn't get acknowledged and there's no one size fits all advice or experience with pregnancy. But I think people think that you know and it comes from the medical system which you've written about a lot Family, friends online, just people randomly, you know, in the workplace or something. What should we do around this?

Isabelle Oderberg: 7:07

I don't think that anyone well, I mean, obviously, when you're suffering from grief, grief isn't rational and there's a lot of thoughts that don't necessarily make sense to people outside of either yourself, your close family, your friends and other people who've experienced this form of loss.

Isabelle Oderberg: 7:25

But I always think I've never had anyone say to me, in all my time of writing about this issue, that they were upset or offended or hurt when someone walked up to them and said look, I'm really sorry for your loss, whereas a lot of people have said I don't understand how you can experience a loss and everyone just ignores it like it doesn't exist. And I think that part of that relates to miscarriage and the confusion around miscarriage and whether or not it is actually a loss. And so you know, is it really a loss if you've lost a baby at six weeks or eight weeks gestation, like if, even if you approach always, I mean, there are all these sorts of questions. So I always encourage people like, if you know that someone has had a loss, you say I'm really sorry for your loss, I hope you're doing okay. If there's anything you need, please let me know, just like you would anyone else who's had a loss or grief in their life. You know, I don't think you can get in trouble for showing kindness.

Emily Webb: 8:22

It's a really hard time, isn't it? And I think that pregnancy represents so much hope Hope for the future can be a really hard experience to get pregnant, so I miscarriage. It's like the loss of a lot of dreams and hopes, I think.

Isabelle Oderberg: 8:36

Yeah, I mean, that is actually the kind of the nugget there which is hopes and dreams, and I think the confusion around early pregnancy loss in particular is that it's like, well, it wasn't a baby. You know when you get pregnant and this is, you know, through cultural imperative, but also, I think, the excitement of being pregnant with a pregnancy that you potentially do really want and you create, you know, that person, that little baby in your mind. So you, you know it's called personification, it's very well understood. But you might see, you know your child, you know what color eyes they have, what color hair they have, what profession they're going to do, how they talk, funny things they might say or do, and you might be picturing that child when they're 18, you might be picturing that child when they're having their own children.

Isabelle Oderberg: 9:23

What were my grandchildren look like? I mean, the imagination really does, you know, run away when you're pregnant and there are all these hopes and dreams and you see other families with toddlers and you say, oh, that's going to be me, and will my child look like that or whatever. And so when you lose the pregnancy, you've in your mind like you've lost a fully formed baby, you know, and so it doesn't matter that it's actually a blastocyst or a fetus or you know whatever you want to medically term it. In your mind and in your heart, that's your child or the potential for your child and you've lost it and it's incredibly painful for most people. Not everyone has that has that reaction, but I think a large number do.

Emily Webb: 10:06

Yeah, and I found it really, really interesting in your book because you do look at portrayals of miscarriage on television movies and it reminded me I was watching the, the new season of Sex and the City, just like that, the reboot. In the latest series one of the characters experiences a miscarriage and she had conflicting feelings because it was a, she was older, her kids were older, she was in her career and she had conflicting feelings about it and had the miscarriage and felt really guilty. And I know that all women, I guess, are upset. They have a miscarriage maybe, but there's complicated feelings. What did you discover through your research about that?

Isabelle Oderberg: 10:46

Yeah, I actually watched that episode and I was really disappointed. So there's a trope called the convenient miscarriage right, and it's basically like miscarriage in order to help the storyline along.

Isabelle Oderberg: 11:01

So it might be that you know it's a young person who doesn't want to have an abortion, because you know, abortion can still be quite controversial in some culture. So instead of having to make them get an abortion, they have a miscarriage and you know it's just a convenient plot line to fit in. I felt very much that that was the convenient miscarriage. It was like they just want to make a point which was that she was sort of not done with that time of mothering and that she was ready to move on and really focus on her career and make it about her and da-da-da-da and like there are. There are a multitude of ways that that could have been done without inserting the convenient miscarriage, which feels dismissive. And you know, of course it happens, but there are so few good depictions of miscarriage in popular culture that it feels particularly disappointing when it's glossed over in that way and it and it happens a lot.

Emily Webb: 11:54

And so for listeners and they'll read more about it in your book for you what is a very genuine, powerful representation of miscarriage in our popular culture and entertainment's not the right word. You know what I mean in film and television.

Isabelle Oderberg: 12:08

Exactly what you mean. I mean I think there was one on Six Feet Under which was particularly good. I thought there was also on Grey's Anatomy had some very good depictions. There was more than one, I think, on Grey's Anatomy. But you know it's funny because I did a lot of investigative journalism around. Particularly I got sucked into a world of pollution and environmental factors and those sorts of things that are hurting our fertility and, in particular, causing miscarriage and adverse outcomes in pregnancy, like preterm birth and things like that. And you know I was really proud of that work because it was really gruelling and kind of depressing and it ended up sort of pushing Ranskog to update their guidelines for people who are pregnant, which was like a really big source of pride.

Isabelle Oderberg: 12:57

But that wasn't the thing that sent my book viral on Reddit. The thing that sent my book viral on Reddit was the confirmation that Chili, who's Bingo, and Bluey's mum had a miscarriage. And Blinken, you miss it, momen in Bluey that a lot of people had interpreted as miscarriage and I was like what? I'm a massive Bluey fan. I must have missed that and I went back and, sure enough, it was like a split second but I actually chased down Joe Brum, who's the writer of Bluey, and confirmed that it actually did represent a miscarriage. And you know, that was the thing that got my book going viral on Reddit, which was great, but it was a very mixed, mixed emotion at the time.

Emily Webb: 13:36

Yeah, yeah, after all that research, it's almost like you're Erin Brockovich type, like absolute advocacy. But it's really interesting about the environmental factors, because I know, I'm aware, that women who were with people who were in Vietnam experienced miscarriages, birth defects, things like that from exposure to Agent Orange, things like that and I think I've read somewhere in I might be Michigan like pollution, like pollution in the water, lead can cause things. What was the probably most startling thing that you discovered about that really deep research? Because that's really important, because it's not just oh, it wasn't meant to be, your body couldn't do it. There are factors that contribute to miscarriage, aren't there?

Isabelle Oderberg: 14:21

Okay, but there is also a whole lot of sharing. I mean Mm, hmm, okay, then 50%, or maybe a touch more, of miscarriages are caused by chromosomal abnormalities. So that's where the egg, which is the process of meiosis, which is the process of the egg dividing up, doesn't happen evenly and you end up with the wrong number of chromosomes. Those pregnancies are not viable and meiosis, which is the dividing of the egg, is thought to get more unreliable the older a birthing parent gets. So the birthing parent and also the producer of the sperm, we can't miss, you know, we can't miss them out. It's all it takes to, so to speak. So that's probably the primary, you know, one of the biggest causes. And then you've also got a number of sort of autoimmune and inflammatory issues in the body that can cause miscarriage or make miscarriage more likely. But one thing that I was looking at in particular in my research was pollution and environmental factors. So this could be anything from bushfire smoke or heavy air pollution at an intersection where there are a lot of cars all the way through to like the plastics that we have in our home, the shampoo that we put on our head. You know there are a lot of different inputs, so to speak. And this isn't to say that you know, if you get caught in a busy intersection and you're not wearing a mask or something like that, that you're going to have a miscarriage, but what it does is it raises your risk profile if you're constantly exposed to things like particulate matter, and the reason for that is that they cause inflammation in the body. I think the thing that scared me the most was just that there is so much that is affecting our biology and also like our DNA that we just don't, we're not really fully educated about. And what I found was that even myself, when I was reading about it, I was sort of dismissive, like, oh, this is quack stuff. You know, this is ridiculous, this is this, is that. And actually, the further I went and the more scientists I spoke to, it's actually really genuinely proven in science. It's very much like you know, I'm talking about large-scale peer-reviewed studies. I'm talking about professors at University of Melbourne. It's really genuinely frightening how much there is in our environment that is affecting our bodies and raising our risk profiles. And I think as well, the lack of regulation and understanding into some of the agrochemicals is really scary. We've got things that we're allowed to use here, that abandon the US compounds and things like that, and it does affect us. It gets into the water supply, it gets into our food, you know, and it's really scary, like it's really genuinely scary.

Isabelle Oderberg: 16:58

And I remember saying to one of the primary people that I interviewed for that section, who's Mark Green, who's an associate professor at University of Melbourne and also sits in Monash IVF, you know, and I was talking to him about it and I just said like this is nightmare stuff. And he said yeah, and I said how do you sleep at night? And he goes we just have to turn off, you know. And I sent him the chapter on the environment before I went to print, because I said to him I don't want to be too kind of alarmist, I want it to be taken seriously, because I felt like it was a little bit like dramatic and whatever. And I sent it to him and he just said this isn't even remotely alarmist, this is a very calm compared to the sort of what we're facing as a species.

Isabelle Oderberg: 17:39

You know this is not alarmist at all. This is very calm and very rational and that's really, really scary. I don't know if I can say fucking but I just did.

Emily Webb: 17:47

You can, you can, and that's the thing. The book covers so much, it's so useful. I mean, I just found it really fascinating and I think the way that people who are experiencing pregnancy and also their partners, their friends, families it's really interesting, and you explore the ways medical treatment is failing people. You refer to it as medical misogyny, and that reproductive justice has to be centered in pregnancy care and early pregnancy loss. Can you talk more about this, especially for people who may not be aware of what it means but they probably recognize it in, maybe, their experiences?

Isabelle Oderberg: 18:25

So, in terms of reproductive justice, this is really really misunderstood. So a lot of people, when they think of reproductive justice, they think of access to contraception and abortion right. That's not what reproductive justice is. That's like a tiny, minuscule part of it, but an important part don't let me dismiss it. But it's a very small part.

Isabelle Oderberg: 18:45

Reproductive justice is the combination of reproductive rights and social justice right, and this is a movement that was started in the US, and Loretta Ross is the person that I kind of quote most when I'm talking about reproductive justice. She's one of the civil rights campaigners that kind of coined the phrase, and it was started by a group of African American civil rights activists in America and what it means is that everyone should have the right to not be a parent, but also everyone should have the right to be a parent. So that encompasses everything from sexual health and sexual health screening and all of those things, all the way through to IVF access or access for genetic testing or any of those things. It's the entire and also choosing when not to become a parent, meaning access to abortion, access to contraception, access to all of these things, and so it's a far more broad concept than what we assume it to be in Australia. And the most important thing is that at the centre of this movement should be the people who have the least access to all of these things, and they are minority groups like Aboriginal and Torres Strait Islander families, people of colour, people for whom English is their second language, lgbtiq plus people and people with a disability and anyone else who would fall into any similar category and be considered a marginalised group.

Isabelle Oderberg: 20:17

And the reason that you centre them first is that we've tried trickle down. Trickle down doesn't work. What you have is a lot of white privileged birthing parents who can access abortion, but you have a huge number of people, for whatever reason whether it's because they don't have the financial means or they don't have the geographic, optimal geographic location or anything else can't access those same services. Ivf is another great example, like why should someone with money be able to parent while someone without money cannot, because they can't access the same medical technologies? And then you also have the issue of parenting and safety. So you have the issue of, like Aboriginal and Torres Strait Islander families who are constantly in fear of their children being taken away. They should be allowed and supported so that they can parent in safety.

Emily Webb: 21:10

Yeah, thank you for bringing that up. That's really interesting and I actually, I'll admit I did not fully understand the concept of reproductive justice. Your book really helped me. And Isy, what about medical misogyny? What does that mean? Because we know that medicine and treatment is often very patriarchal. Let's face it studies for different things are often based on male biology.

Isabelle Oderberg: 21:38

Misogyny is sort of ingrained into so many different elements of society. But I think in medicine it's there's zero question, your right. Studies often are based around the male anatomy and male stem cells, even male animals when they're doing animal testing. You know, I highly recommend anyone interested in the topic of medical misogyny read Pain and Prejudice by Gabrielle Jackson, which was one of the absolute guiding lights when I was writing my book, and I'm lucky enough to call Gabs a friend and I just can't emphasize enough that her book is so, so interesting. But you know, there are so many aspects of it that it's so overwhelming and when I get asked about it I'm like I don't even know where to start. I still haven't figured out where to start. But like everything from like even even the rebates for women's healthcare is is like so far behind. You know, like a man's pelvic screening attracts a higher rebate than a woman's pelvic screening, even though women have many more organs down there, many more likelihoods of cancer and things like that. Often anything gynecological is considered male doctors this is. You know, studies have shown this.

Isabelle Oderberg: 22:53

Male doctors will often say, well, I don't do that kind of medicine. You know male GPs and refer women on to female GPs. There's certainly in emergency rooms, gynecological or obstetric complications like whoa. We don't do that, that's you know. That's a different department altogether and it goes all the way through to the fact that you know, often, for instance, when women present with a heart attack in ED, it's less likely to be diagnosed because it presents differently to a man's heart attack and so often it's not diagnosed because they don't know that and they don't realize it's terrible, like it's just really bad.

Isabelle Oderberg: 23:33

And the other thing about miscarriage is that you know, miscarriage is a sentient marker for other health issues that present in women, such as, you know, thrombosis and cardiovascular issues. You know, but we, we still don't, I mean we don't collect miscarriage data in this country. We don't even know, you know, where it's affecting people the most or least. But yeah, in terms of, in terms of, you know, medical misogyny, like it, is so deeply ingrained and it's probably one of the biggest challenges. But this government, this federal government and Ged Kearney in particular, you know they have acknowledged it. They've set up a council to try and establish how to how to fight it. I mean, you know there is progress being made but, as with cultural issues, it takes a long time.

Emily Webb: 24:17

And what we do know is how many people experience miscarriage a year in Australia.

Isabelle Oderberg: 24:24

It's really difficult to say. There are studies like the most conservative would be say 15%. So you know something like one in five, just under one in five. More likely is one in four, which is 25% of pregnancies that are known of, like, known about, and then it could be as high as 30%, which is like one or 33, 32, 33, which is about one in three. So that's why we say up to 150,000 families. That 150,000 number is the one in three principle, but with recurrent miscarriage removed, so I think it's higher than 1.4.

Isabelle Oderberg: 25:06

That's my gut feeling, based on speaking to doctors about whether they think miscarriage rates are going up, down or sideways. Every single medical practitioner that I spoke to in Australia or overseas believes that rates are going up. So I think one in four was probably more realistic 20 years ago and I truly believe that now it's somewhere between 1 in 4 and 1 in 3. But this is why we need to miscarriage and can be a bit of a canary in the coal mine on a number of different things, whether it's environmental issues in a particular region or geographic access to prenatal care or nutrition areas where nutrition is not good. There are all sorts of different miscarriage that can indicate, if we were mapping it, if we were looking at it, if we were actually interested in seeing whether those numbers were going up, down or sideways, or only in particular areas.

Emily Webb: 26:06

I wondered if Family Violence is taken into context as well

Isabelle Oderberg: 26:12

so Family Violence is really interesting as a factor In some cases where someone is not grief-stricken by a pregnancy loss. Often there's Family Violence in the home.

Isabelle Oderberg: 26:28

But having said that, people who get pregnant and are fearful because it can encourage Family Violence in the home does that make sense An unwanted pregnancy, and so that's where the sort miscarriage relief comes into play, and I have interviewed people who've had that experience, and then you have. Also, ms Carriage is more likely in a context where there is Family Violence, but that is complicated by. So when we talk about intersectional disadvantage, people think that it's like this crossroads, and it's not the way that Kimberly Crenshaw defines it, and she was the person who coined the term. Intersectional advantage is that it's layers of disadvantage that sit on top of each other to create an overall higher risk profile for things like criminalization or adverse health outcomes. And so what happens is in terms of Family Violence. Family Violence can lead to higher miscarriage rates and people sort of think, oh well, that means that someone's been hit and they've lost a pregnancy. Not necessarily the case. What happens is that Family Violence is more likely to occur in low-income households and in certain demographic. Low-income households also are more likely to have higher miscarriage rates because of things like nutrition, things like the kinds of work that they do, the kinds of exposures that they have at work, that sort of thing. So, yes, family Violence is a risk marker. It elevates your risk of miscarriage, but not necessarily due to the violence itself. It indicates that you're more likely to be in a risk profile with things like lower income or whatever. But then it also indicates that you know that they're less likely to be grief over a miscarriage.

Isabelle Oderberg: 28:19

And that's not to say that people who experience Family Violence are not grief-stricken. There is no absolute here. There are all sorts of different contexts and we just have to be really broad in the way that we look at those. Having said all of that, you know, in the book what I've really really tried to do is I was really proud in one of the reviews because the reviewer said nothing goes uninterrogated. And that's what I wanted to do. I wanted to interrogate every position, every conclusion. There is no one-size-fits-all when it comes to grief, miscarriage. You know intersectional disadvantage, layers, a disadvantage, all of those things and we have to consider a range of different experiences and that's really what I've tried to do. So I hope that answers the question about Family Violence. It's certainly not a straightforward black-and-white thing.

Emily Webb: 29:06

No, no, that was really really good and really informative. Like I really learned a lot from that and I think listeners will as well. And you know, this podcast focuses a lot on mental health, because ermha365, you know, is a provider of complex mental health services, and we also look at the intersections with economics, society, racism, everything, because it all intersects. Your experience and that of other people you spoke to, for this book encompasses not just the physical, but spiritual, social and mental. What do you want people, I guess, to understand about pregnancy loss, early pregnancy loss? And also, would this also relate to people who are experiencing fertility treatments or for whom getting pregnant is complicated, because we know that there is a mental health impact?

Isabelle Oderberg: 29:53

So I think one of the things that's like not understood about miscarriage is that the mental health impact of miscarriage can be just as high as stillbirth. It isn't always, but it can be. There can be suicidal tendencies, there can be PTSD, there can be all kinds of different things. And you know, it's interesting. I went to the Australian peak body for psychologists in Australia and I looked at. You know, when you go to their website to find a practitioner, there's like a drop-down menu of specialties and miscarriage isn't in there and it's something that affects so many people and like it affects the birthing parent, but it affects the partner, it affects their grandparents, it affects other siblings, it affects, you know, friends.

Isabelle Oderberg: 30:37

I mean I have a best friend who got pregnant. What you'd say is comparatively late. I think she was 40 maybe when she got pregnant, or maybe even 41. And when she was going for an IPT test, which is a non-invasive prenatal testing, which is where they test the cell-free DNA to see if there are any chromosomal abnormalities that the parent might want to know about, she called me and she said hey, you know at what point did you get your Downs diagnosis for you know your last pregnancy, and I mean her supporting me through my miscarriages and my losses affected her and her well-being during her pregnancy, because she'd seen the worst that pregnancy had to offer, and so I think that is really downplayed and like misunderstood, and so I think that's one of the mental health effects.

Isabelle Oderberg: 31:24

And what's really interesting is that there is this concept, the TLC concept, which is they did a study in the UK and it was run by is not first study that's shown this, but it was, you know, recent and done by professor Dame Lesley Regan, is like probably one of the world's leading miscarriage researchers, but also was appointed the first ambassador for women's health in the UK. What they found in this study was that we know that subsequent pregnancies after a pregnancy that ends in miscarriage is affected by mental health. There's much higher levels of stress and anxiety. It can also affect the way that we parent our children when they are born, because, again, stress, anxiety, fear, all of those things. And what they found was that birthing parents who were given support in subsequent pregnancies so that might be psychology appointments, counselling, check-in, phone calls just to see how you're travelling, and more scans actually had better outcomes. They had more likelihood of a successful pregnancy the second time around.

Isabelle Oderberg: 32:27

And when I was interviewing her about it, I said you know, you're so, you know you're so medically driven and you're so you know, like how do you, how do you kind of make that make sense, you know? And she said it seems like such a non-Professor Dame Lesley Regan conclusion to reach that tender, loving care could result in, you know, better pregnancy outcomes. And she just said I'd like to think that if we were all a little kinder to ourselves and the people around us, that everything would be better. But she said there is zero question that supporting people in subsequent pregnancy has better outcomes. And like if that is not evidence that mental health is important in how a pregnancy goes, like I don't know what is.

Emily Webb: 33:06

And in fact just so good, because you covered off some of the points I wanted to cover. You know about parenting and also partners. If I'm able to ask, how did Hasbo go? Because partners are trying to support the partner, but they're also experiencing their own stuff. You know, I think it's only really recent times where the mental health of, say, fathers or co-parents or however it is they can experience a kind of postnatal depression too or an anti-natal depression.

Isabelle Oderberg: 33:36

So, yeah, the partner thing. Okay, there's so much to unpack I never know where to start. Okay, so my husband is Aboriginal and has dealt with much trauma in his life and he's very unfortunately, he processes trauma in an efficient way. There were only flashes where.

Isabelle Oderberg: 33:56

I saw his grief, but they were very painful for me to witness. What I would say is that the thing that he struggled the most with because he doesn't tend to be one of those people who thinks ahead he hadn't necessarily pictured the babies the way that I had. I'm a planner, he's a sort of live each day as its own sort of personality, but watching him watch me was hard. He didn't like it. He asked at one point if we could stop. You know, he really that's the bit that he struggled with the most was watching my grief and, you know, being sort of powerless to do a lot, and I think he also struggled with the disruptiveness of it.

Isabelle Oderberg: 34:37

I think that people who experience pregnancy loss often have relationship issues in the aftermath. Part of that is the contribution of toxic masculinity in the way that I think in hetero couples which are not the only couples, but certainly make up the majority where the male partner is sort of like they think that they should just be stoic, and so what happens is they put on a brave face. Actually, male partners often suffer the same grief levels as female partners, but they don't necessarily show it and then the birthing partner thinks that the male partner doesn't care, and that's where a lot of insort of qualitative research it comes up again and again, like I just wanted to know that they were hurting too, that they were experiencing similar things, and that is a result of the toxic masculinity that we find ourselves living with in society.

Emily Webb: 35:30

That's really, really interesting and powerful to me, and I think it's when you see glimpses of that and you don't necessarily recognise experiences yourself. I did a previous episode with a woman who experienced a very traumatic birth and had a very significant injury with pelvic organ prolapse and is actually experiences disability from that and she spoke a lot about you know how it impacted her relationship before. You mentioned that pregnancy loss can actually then impact how you parent and through your pregnancies that result with living children. What was your experience?

Isabelle Oderberg: 36:09

So I ended up with a really gnarly anxiety disorder as a result of my pregnancy losses. I would say previous to that I had had what I would describe as manageable regular Jewish woman anxiety and neurosis. And as each pregnancy loss racked up, my ability to kind of believe that things were going to work out just eroded and eroded and eroded and the anxiety went up and up and up. After my second living child was born, I did go back into therapy. I've been in therapy pretty much, you know, since my 20s. I had a history of clinical depression and I went back into therapy and I struggled. I mean, the last pregnancy of my daughter was the worst, like the worst eight months, nine months of my life, without any shadow of a doubt. It was just constant fear, constant like calling my obstetrician and saying the baby's dead I'm sure the baby's dead and having to have scans and all that sort of stuff. It was awful and recovering from it was really hard. But about two years after she was born I went on medication and I'm so much happier on my anti-anxiety medication. It has helped me enormously.

Isabelle Oderberg: 37:24

But that is my scar tissue. My scar tissue is my anxiety, which now isn't always manageable. I sometimes need help to manage it and I think zero surprise that I get very anxious about my kids and their safety, and I think every parent has anxiety about their kids. But I think sometimes it can be like, ok, you know, my husband will say you need to dial it back, like you're beyond what would a healthy, healthy, healthy anxiety level, you know, and I'm also very conscious not to put that on them. I don't want them to be anxious, which they're not. They're very relaxed kids, which is great. But I have to be really conscious of not giving that to them because intergenerational trauma is real, you know.

Emily Webb: 38:03

Oh yeah, yeah, Like we are learning more about that, aren't we? And particularly for your husband, who is Aboriginal, would know a lot and you're Jewish as well. So I mean, you know, I don't have that experience, but I've read a lot and heard a lot of people speak about it. I hope that's OK to say.

Isabelle Oderberg: 38:20

No, absolutely fine. I mean I don't think there's any shortage of, you know, in people who actually read or watch TV or whatever. You know the Holocaust is well documented and I am the descendant of Holocaust survivors, so you know that is part of it. But I mean, so you know, my husband and I are very conscious of not, you know, passing intergenerational trauma onto our kids. But certainly I never expected to kind of gain my own massive trauma the way that I did and then have to be even more hyperconscious of not passing it on.

Isabelle Oderberg: 38:51

But I am, so that's where we're at.

Emily Webb: 38:54

We ask this of all, I guess Isy, what today does self care and looking after your mental health look like for you and what's been really helpful?

Isabelle Oderberg: 39:02

Since the book was released. I mean, I have two little kids, I have a day job, I have my book, which I'm promoting, which I wrote, went through the editing process and promoting and actively promoting, and now I've set up the early pregnancy loss coalition, which is a cross-sector coalition of people in the miscarriage space to try and get their outcomes in research funding and frontline support funding and that kind of thing, and I also have a business that I run on the side as well. So I am very busy all the time. I don't get a lot of downtime and probably the best thing for me right now has been learning to do my nails. And every night, every sorry no, every night, my gosh, that would be intense. No, every, say, two weeks or so, I sit down and I spend three hours and I design these really intricate you know intricate nails, I noticed your nails.

Emily Webb: 39:52

Actually, I was looking at them because I bite my nails and I have to get nails to stop it. And for listeners, Isy's nails look amazing.

Isabelle Oderberg: 40:03

So at the moment they're like a French tip but with a black and silver sparkle, but, like, honestly, it forces me to sit down in a chair, watch three hours of like you know, rupaul's Drag Race or something else that makes me smile and I just do my nails and I think that that enforced time of care is great. The other thing I would say is I do personal training twice a week, which is like my big splashy spend, but for the first time since giving birth, because I have an injury, a pregnancy injury in my back. I don't have any pain in my back, I have. I'm really strong, I can pick the kids up, I'm really happy. So that's, that's my two personal care things that I do.

Emily Webb: 40:47

Lovely and I actually think things like that. They're also very calming, like meditative almost, and I really we always hear so many great things. I think that doing that for yourself is so cool. So the book is out. It's really great. What's the reception been like? And you've already had some really amazing results. As you mentioned, some guidelines were changed. What are you hoping for the book and what's been some really great outcomes from it so far, or feedback?

Isabelle Oderberg: 41:15

I mean, I've had good reviews, which has been really, really nice for my ego and because this book is so intensely personal. You know, one of the best bits of feedback that I got was someone I know, a friend, who read the book and said I had no intention of reading the book. And I read it. And I, because I just thought it wasn't for me, like this is someone who doesn't have children, doesn't want to have children, you know, and but is is identifies as a woman, and she read the book and she just said I can't believe, I thought that it wasn't relevant to me, like it's a really, really broad book. It includes a lot of stuff about, you know, portrayal of women in the media. It includes stuff about the environment and how it affects our fertility and it includes a lot about grief. It includes a lot about abortion and feminism. You know this. It's a very broad book because miscarriage is a very broad issue. So I think that really stunned me because I was like, oh my gosh, that's amazing. I want it to always be there for people that need it, but I think that I want more than just people who experience miscarriage to read it.

Isabelle Oderberg: 42:22

Promoting the book has had its challenges in that often I'm told it's not a palatable topic for this primetime TV show or whatever, and I find that really, really frustrating. They want to run a story when there's a celebrity who's had a miscarriage or whatever, but they don't want to unpack it as a real issue. They just want to be like oh how sad, trauma, porn, terrible. But in terms of actually unpacking it and moving forward, there can be a bit of resistance. This issue sits in the cross-section of two of the things that make us most uncomfortable in the world as a society, which are grief and vaginal bleeding. It's like, oh my God, people are running from it. It's the topical Godzilla or something it's pretty ridiculous to watch. But I hope that people read the book and find something in it that they didn't know maybe more than one thing and that it helps people understand these concepts and these challenges and helps us move forward in a practical way.

Emily Webb: 43:24

Isy before we wrap up. What are you working on next? Have you got any projects on the go? I'm sure you do.

Isabelle Oderberg: 43:31

I always have projects on the go, but at the moment I'm working on a kid's book, so it's still very much a work in progress, but I'm really enjoying it and my agent is happy with how it's coming along, and that will be my next project. And then after that there's another book I think I may write, but I am certainly not in the fiction arena. I have zero interest. I am not a fiction writer. It'll be another nonfiction book, probably journalistic in style. But before that happens I think it will be my husband's turn to write his book. So he's currently working on two books and I think we'll take it in turn. So I love that. So I'll write my book and then he'll write a book and I'll write a book and we'll see where it goes.

Emily Webb: 44:14

That's great. I love that and I'll look forward to you next what you're doing next. Before we finish, any final thoughts for listeners.

Isabelle Oderberg: 44:21

Look, I guess all I can say is thank you for having me on the show and being willing to unpack this issue. Please buy my book or borrow it from your library If there are any topics in this conversation that have interested you and, if you like it, tell a friend and pass the word on, because the more people read this book, the more likely we will actually be to change the culture and make things better for everyone. So it's very much a work of passion and I hope that you get read it and get something out of it.

Emily Webb: 44:52

A big thank you to Isy Odeberg for joining us and you can find out more about Izzy and her book at the website hardtobearcom. We'll have details in the show notes as well as other resources related to our discussion in this episode. Thanks for listening to Get Real and if you are enjoying this podcast and finding it useful, tell your friends and rate or review on your podcast listening platform. It helps other people to find our conversations. If you've been affected by anything discussed in this podcast, you can phone Lifeline on 131114 or go to lifelineorgau.