First Heartbeat: A Tale About Miscarriage

Journalist Lisa Francesca Nand suffered multiple miscarriages. She and her husband – a psychotherapist – began documenting these painful, traumatic experiences on camera and the resulting film was broadcast on TLC Network…

Lisa Francesca Nand, 41, was a newsreader for the BBC then a presenter on TalkSPORT before going freelance. She’s now a travel expert on BBC1’s Rip Off Britain, is regularly on the radio, writes for national press and makes films

When I speak to Lisa Nand, she’s on holiday in Spain with her husband David and their two sons: Sebastian, three, and Elliot, eight months. “Well, part holiday, part work,” she says, “as a freelance journalist you rarely switch off.” This is certainly true with her latest project, which merges work and personal life.

I first heard Nand talk about her documentary First Heartbeat – broadcast on TLC this month – on Woman’s Hour. Listening to her recall intimate details about the succession of miscarriages she endured I felt solidarity, as a fellow mother.

The joy of discovering a wanted pregnancy will often be laced with fear that you might lose the baby. For this fear to be confirmed, repeatedly, can be utterly devastating – for both mother and father – and yet it remains a largely taboo subject.

With one in five pregnancies in the UK resulting in miscarriage – possibly more, as some happen before the pregnancy has been detected – and one in 100 women experiencing recurrent miscarriages (three or more), it is really very common. So why don’t we talk about it?

“It puts you centre stage,” says Nand. “When you expose yourself as wanting a baby and yet failing, it can make you feel very vulnerable. Everyone’s watching you – noticing every drink you refuse, wondering if you’re pregnant again.”

But she thinks we need to change the “cult of silence” surrounding the first 12 weeks of pregnancy. “Surely if you do miscarry, you want the support of people around you. If someone you love dies, you tell people. So why keep a miscarriage to yourself?”

If the pregnancy has been a secret until that point, she says that people might not understand the grief you are experiencing. “You’ve had weeks and weeks invested in pregnancy. You might have been trying for a year then you the lose baby. But if people weren’t aware, they won’t understand your pain.”

People don’t generally talk about miscarriage and so the mechanics are quite unknown. In TV and film you don’t get a sense of how physically painful it can be

Nand went through two miscarriages in her 20s – “I didn’t want children at the time so although upsetting, I brushed them off” – but after marrying in 2011 and losing the baby at 12 weeks, which is considered a late miscarriage, it hit her that there might be a problem.

It was “brutal and horrible, painful, shocking – life-changing,” she says, “so I started researching to work out why it happens. That’s when I realised there’s not much support out there.”

She found comfort in the online community, particularly Mumsnet. “I wasn’t even a mum. And I didn’t think it was where I’d find myself if I had been.” But it became her go-to and she wrote a blog for them about what she was going through.

After requesting a referral from her doctor to see a specialist – something not all doctors will offer, as “they might not know it’s out there” – she had an appointment with Dr Hassan Shehata, who runs the Miscarriage Clinic, and he diagnosed her with a high level of natural killer (NK) cells, which were killing off the baby as a foreign object.

“Treatment was relatively simple – taking steroids initially then, once pregnant, a soya and milk infusion to help dampen down killer cells”. You can be seen on the NHS but Nand paid to go privately because she felt like she was “in a hurry”. The treatment for some women can be as simple as taking one aspirin a day to reduce blood clots.

Her raised levels of NK cells were due to an underlying thyroid issue, but Nand explains that people who have eczema, asthma and various other conditions are also more likely to have high levels.

She’s keen to point out that miscarriage is not the fault of the mother. “People run marathons when they’re pregnant. They’re smack addicts – and the babies are fine. That one glass of wine or run or heavy-lifting is not going to have caused your miscarriage.”

“There’s a lot of guilt involved, which is really misplaced – the most common cause is chromosomal, and there’s nothing you can do about that. But there are conditions such a blood-clotting and progesterone deficiency, which can be treated.”

It was after her third miscarriage, two months into her marriage with David, that Nand decided to start filming her journey. Initially, being a journalist, she was interviewing “key players: doctors – who I discovered all have different opinions on this subject.” And on the side, she filmed a video diary.

You remember your due date, when the baby would have been born, what would have happened at Christmas

But rather than the interviews, it was the raw, personal footage that the film companies were interested in: “they wanted the emotional side,” so she turned the film into an autobiographical documentation of what she was going through.

“Initially, it was hard to open up on camera,” she says, “I’m used to presenting professionally, but I remember saying I couldn’t cry.” After a while, the camera became “a bit of a friend. I managed to open up”.

Not having people in real life to speak to, except the online friends she’d made on Mumsnet – “they became a massive support” – she began enjoying being able to confide in the camera, as you might a normal diary.

David was apprehensive at first, but went on to film an important part of the film. After dropping his wife off for the crudely named ‘evacuation of retained products’ operation he filmed himself sharing his feelings. With tears welling up, he discusses the pain he’s going through, witnessing his wife’s vulnerability.

He had felt like his role was reduced by being the camera man at hospital meetings, rather than the supportive husband; feeling it distanced him. But as a psychotherapist, he could see the value in what he and his wife were doing – opening up about something that isn’t usually spoken about.

For Nand, the filming process was “cathartic, therapeutic. To have a purpose – that helped me. I was able to objectify it. It was a terrible experience but the camera helped me to distance myself.”

The film is utterly harrowing in parts, shocking in others. For instance, when Nand discusses the physical pain of her miscarriage at 12 weeks – “excruciating cramps, my body wracked by contractions for hours” – and then bleeding for six weeks, while still experiencing the effects of the pregnancy hormones.

“People don’t generally talk about miscarriage and so the mechanics are quite unknown. In TV and film you don’t get a sense of how physically painful it can be. It was emotionally draining – you’re mentally preparing for baby so it comes as quite a shock.”

The emotional turmoil then continues, she explains, as you’re thinking: “I should be four weeks on now, having my 20-week scan. All these things you’ve marked off – you remember your due date, when the baby would have been born, what would have happened at Christmas.”

To cope during this period, she went out a lot and drank. “Not in an alcoholic way – but I’d been pregnant so hadn’t been able to have alcohol. I was wondering if I was ever going to become a mum.”

Her experience was quite short compared to other couple’s, she says, who may go through “14, 15, 16” miscarriages. She considered how many she would go through before giving up on having a family. “I imagine I would have drawn a line somewhere but I’m not sure where that would have been.”

Her objective, with the film, was to get people to open up more about attempts to conceive; about losing a baby. “After I started to miscarry, I began to tell people. I’d say: I’ve done a pregnancy test and got a positive, it might not last but for now I am pregnant. Miscarriage is very common.”

She’s been delighted by the press response to her film. “We were trending on Twitter when it was broadcast on TLC,” she says, “there have been articles in the Telegraph, the Mail, the Mirror, the Sun, Bella. I was on Loose Women, BBC news, Woman’s Hour, the Jeremy Vine Show.”

She has also received countless emails from people who have been through a miscarriage thanking her for speaking out – not just for herself, but for them; as they feel united in their suffering. “People are ready to talk about it, they’ve felt neglected until now. There’s this unacknowledged grief.”

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