'I shouldn't have felt guilty for my miscarriages'

Between the births of her two daughters Ellie Goan had two miscarriages

Each year Ellie Goan hangs two special decorations on her Christmas tree, a star and bauble - reminders of the two pregnancies she lost.

The 41-year-old was one of more than 800 women in Northern Ireland who participated in a recently published study about pregnancy loss at Queen's University Belfast (QUB).

It found women frequently reported feelings of isolation and guilt following miscarriage stemming from social stigma and inadequate support.

"You blame yourself, I blamed myself," she said. "I know it wasn't anything I'd done and it wasn't my fault, but it's very easy to say that in hindsight," she said.

Each year Ellie Goan hangs up decorations on her Christmas tree in memory of the babies she never got to meet

Participants in the QUB study were anonymous, but Ellie chose independently to speak to BBC News NI about her involvement.

It was 10 years ago that she experienced her first miscarriage, and she said that while the festive season can stir up difficult emotions, it wasn't until her second miscarriage that her mental health was significantly impacted.

"I was crying all the time, I didn't want to leave the house, I was avoiding friends," she said.

After speaking with her GP Ellie was diagnosed with severe anxiety, a condition she said she continues to manage.

As part of her treatment plan, Ellie was referred for Cognitive Behavioural Therapy (CBT).

"I can't begin to imagine the direction my life would have taken without having had that support," she said.

Ellie Goan, her husband Barry and their daughters Aoibhinn [left] and Etain [Right]

Ellie did not get any scan pictures, so said she has no tangible record of her miscarriages.

"I don't think it matters at what stage you lose your pregnancy once you see a positive pregnancy test, for some women, that's your baby and you start to imagine what way your family's going to look," she said.

"I'll never forget the two babies that I lost."

A recently published study by Queen's University Belfast found women in Northern Ireland who have had multiple miscarriages experience feelings of guilt and isolation

Dr Áine Aventin, a senior lecturer from the School of Nursing and Midwifery at QUB, said the study found that levels of distress following a miscarriage were significantly higher in women who had experienced more than one loss.

She said many women do not share their pregnancy news before the 12-week scan, so if they miscarry earlier, they can struggle to know who to talk to which can be isolating.

Miscarriage often has no identifiable cause, which Dr Aventin said can prompt women to blame themselves.

She added women may accept one miscarriage as bad luck, but when it happens again they frequently start to wonder if they are somehow at fault.

"Is there something I'm doing wrong here, did I have a glass of wine before I knew I was pregnant, am I exercising wrong?," Dr Aventin said.

"These types of things, women tend to blame themselves for and that brings an aspect of guilt."

Dr Áine Aventin said the lack of knowledge around what causes miscarriages can lead women to blame themselves

Dr Aventin said that there are lots of amazing midwives, bereavement nurses and healthcare practitioners, but that services are overstretched.

She said more resources are needed, both to educate healthcare professionals on how to support women after miscarriage and give them the time to provide that support.

"When women have this experience, they're really vulnerable," she said.

"They need sensitive communication, compassion that somebody understands what they're going through is a significant loss for them, even if there isn't a visible baby."

Dr Aventin gave an example of the compassionate care she received after she had a stillbirth when a nurse saved the petals from the roses a friend had sent her.

"With tears in my eyes, I said it to the midwife 'I forgot to water the roses'," she said.

As she was leaving the nurse gave her a box with the white rose petals inside and said she could put them on her stillborn son's grave.

"In the grand scheme of things, a bunch of dead roses was nothing, but this woman understood that, to me, they were Malachy's roses."

If you are affected by any of the issues discussed in this story, details of help and advice are available on the BBC Action Line website.