Wellbeing after Miscarriage programme - part 4

Cognitive Behaviour Therapy (CBT) after miscarriage - thoughts, emotions, physical feelings and how we act.

The spiral of negative automatic thoughts, negative actions and more negative thoughts.

How to recognise negative thoughts and challenge them through journalling - writing down negative thoughts and asking yourself questions about them.

Using journalling in different ways to challenge negative thoughts and actions.

More about compassion and a self compassion exercise.

If you would like to have another go at the self compassion activity, Denise can guide you through it here.

Read or watch more about CBT (Cognitive Behaviour Therapy) here.

If you would like to have a go at journalling on your phone, you could use the My Possible Self app. See what other people recommend by joining our programme Facebook group.

Journalling ideas

• Use your journal to challenge negative thoughts - write them down and then list everything that proves them wrong.
• List things you are grateful for, however small.
• Notice and write down things you have done well or achieved. Getting to session 4 in this programme could be one of them.
• Write down verses, prayers, poems or sayings that mean something to you.
• Take pictures or draw things you are grateful for. You could keep these private or set up a messaging group with someone close to you. Challenge yourselves to share something each day.
   

Challenging negative thoughts about your body. 

Talking positively to your body and congratulating yourself as you go through the session.

Jenni will show you exactly what to do. This is just to give you a general idea. We will also show you an easier and harder version of all the movements. 

Standing:

• grounding and body scan, thinking about posture and core breathing
• arm movements
• foot and ankle movements
• roll down.

Lying on your back with knees bent:

• circles with one leg and pointed toe
• extending legs, one at a time
• scissor movements with legs
• stomach exercises with heel slides and holding legs in table top
• single leg bridge or bridge.

Lying on your left side with knees bent:

• clams
• cycling movements with top leg
• thigh stretch.

Sitting:

• mermaid stretches on right and left side
• hamstring stretches and roll downs on right and left side.

Lying on your right side with knees bent:

• clams
• cycling movements with top leg
• thigh stretch.

On your hands and knees (4-point):

• stretching your glutes
• moving arms and legs out (swimming)
• knee hovers
• cat stretch
• abductor stretch.

Hip flexor on right and left side.

Standing:

• balancing
• sliding with arms forward
• jumping.

Finish with deep core breaths and a body scan.

Try to recognise any unhelpful thoughts you have about your body and speak some positive words to your body instead. 

Write or record a letter to your body. Think of your body as a good friend who has gone through something really hard and share some loving encouragement. We have space to write your letter in our progress tracker. If you have started a journal with Denise, you could write it there or record it on your phone.

And don’t forget to keep doing the pelvic floor connection exercises.
 

Exercises to help reduce your Body Mass Index (BMI), if this is something you want to do. Research shows that high BMI is one of the things that can increase your risk of miscarriage, but this will depend on your personal situation and health.

Shakira will show you exactly what to do. This is just to give you a general idea. Nicky and Jenni will show you an easier and harder version of all the movements. 

You will need a chair for this session. One with 4 legs is better than an armchair.

Warm up:

• marches
• squats with punches
• squats and rotations
• reverse lunges with arms raised
• slow kneel to standing
• kneeling down to child's pose
• cat-cow stretch on hands and knees
• glute kick-backs
• body roll to standing
• deep breathing.

Main workout:

• squats to single leg hold
• inchworm
• tricep dips using chair
• plank on forearms and knees, with rotation
• single leg bridge
• kneels to standing with knee raise
• arm circles and shoulder pulses.

For more support you could reach out to others on our Facebook group.

If you can, it might be helpful to talk to someone you are close to about this course, or even watch it with them.

You can also talk to a Tommy’s midwife for free. You can call them Monday-Friday, 9am-5pm on 0800 0147 800 or you can email them at [email protected]. Our midwives are trained in bereavement support so will be able to talk to you about what you’re going through. If you are Black or Black Mixed Heritage we have a specialist helpline for you, in partnership with 5 X More. Book your call here.

The Miscarriage Association runs support groups in person and on Zoom.

We have more information and support on our website too.

If you are having suicidal thoughts or thoughts about harming yourself or others, call 999 or go to A&E. If you need to talk to someone right now, call  Samaritans on 116 123 or text SHOUT to 85258.

 Self-compassion exercise based on one delivered by Kirstie Drummond Papworth at the Suicide Bereavement UK conference 2024

Generalised anxiety disorder and panic disorder in adults: management. Clinical guideline [CG113] Treatment manuals for cognitive behavioural therapy and applied relaxation. Published: 26 January 2011 Last updated: 15 June 2020

Crawford (2016) Pelvic floor muscle motor unit recruitment: Kegels vs specialised movement. American Journal of Obstetrics and Gynaecology Volume 214, Issue 4, Supplement, S468.    

NICE (2021) Pelvic Floor Dysfunction: Prevention and Non-Surgical Management  

H. Lashen, K. Fear, D.W. Sturdee, Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case–control study, Human Reproduction, Volume 19, Issue 7, 1 July 2004, Pages 1644–1646, https://doi.org/10.1093/humrep/deh277 -

Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years NICE guideline [NG247] Published: 15 January 2025