One in four pregnancies ends in miscarriage. If you are reading this and you have been through one, there is something you need to hear: it was not your fault. Not the walk you took. Not the food you ate. Not the stress at work. One in four, and most women carry the blame in silence for years.

This conversation has been a long time coming. Dr. Michael Azzi from NaPro Life Centre and Dr. Marie Rose Mouawad from Teresa Centre joined Eddie and Joni Raad on Finding Sanctuary to talk about what women actually go through across the full cycle of fertility, pregnancy, postnatal depression and menopause. What they said will stay with you.

Key Takeaways

  • One in four pregnancies ends in miscarriage, and most women blame themselves for something they never caused
  • High risk pregnancy is an invisible struggle that the people around you rarely understand
  • The mental load of pregnancy and motherhood falls disproportionately on women in our society
  • Postnatal depression affects more families than most people realise, and it is treatable
  • Menopause carries a mental health dimension that healthcare often fails to address
  • Reaching out for help is not failure. It is the village working exactly as it should

When Pregnancy Does Not Go the Way You Expected

Most of us grow up with a picture of how things are supposed to go. You find the right person. You build a life together. And when the time is right, you start a family. For a lot of people, that picture is exactly what happens.

But for a growing number of women, the picture gets complicated very quickly. Fertility struggles, miscarriage and high risk pregnancy are far more common than anyone talks about openly. And because nobody talks about it, women going through these experiences often feel as though they are the only one.

Dr. Michael Azzi works in restorative reproductive medicine through NaPro Life Centre, where his approach is rooted in finding the cause of a fertility challenge rather than bypassing it. NaPro technology focuses on restoring natural fertility by treating what is actually happening in a woman’s body and addressing the root cause, rather than adopting a one size fits all approach.

For many women who have spent years in the conventional healthcare system feeling like a number, that approach alone is a form of hope they had stopped believing in.

Dr. Marie Rose Mouawad established Teresa Centre to serve women at a different point in the journey: those facing unexpected pregnancies, those struggling through difficult pregnancies, and those navigating the aftermath of birth. The centre offers practical support, counselling and a genuine community for women who might otherwise go through these experiences completely alone.

The Guilt Women Carry

When something goes wrong in a pregnancy, the first question most women ask themselves is what did I do wrong. Dr. Marie Rose Mouawad sees this every week. Women who have experienced miscarriage arrive carrying an enormous burden of guilt, convinced that something they did or did not do caused the loss.

“A lot of the time it is not like that. One in four pregnancies actually ends in miscarriage. And that is not the result of anything a woman has done.” — Dr. Marie Rose Mouawad

This guilt does not stay in one place. It moves. It follows women through pregnancy, through motherhood, and into every stage of life where they feel like they should be doing more. As Eddie and Joni explored in the episode, this guilt becomes something deeper than a passing thought over time. It becomes a belief. And once something is a belief, it is embedded. It shapes how a woman sees herself, how she makes decisions, and how she responds to the people around her.

Shifting a thought is relatively straightforward. Shifting a belief requires something much more significant: time, support, community, and often professional help.

Joni’s Story: High Risk Pregnancy and the Weight of Knowing

Joni Raad was told she was infertile. Three weeks later, she found out she was pregnant.

What followed was one of the most quietly courageous stories shared on Finding Sanctuary. Joni describes sitting in a surgeon’s office, watching him read her paperwork with a pained expression, and having to stop him to tell him she was actually pregnant. The look of disbelief on his face told her everything she needed to know about how serious her situation was.

The doctor mapped it out for her. At six weeks, this might happen. At twelve weeks, this. If they got to sixteen weeks, modified bed rest. At twenty four weeks, a viable birth. She would likely deliver somewhere between twenty eight and thirty two weeks.

“You wake up every day and you are like, is today the day where I lose my child?” — Joni Raad

Joni made it to thirty seven and a half weeks. Twice. But she is honest about how hard that road was, and about the particular loneliness of carrying a high risk pregnancy in a culture that responded with gratitude and celebration while she was waking up every morning not knowing if the pregnancy would continue. She was grateful. And she was also terrified. Both things were true at the same time, and there was almost no room to say so.

She shares her story not because it has a tidy ending, but because women going through high risk pregnancy deserve to know they are not alone in what they are feeling and what they are carrying.

The Village That Was Never There

There is an old saying that it takes a village to raise a family. Dr. Michael Azzi raised it in the episode and it resonated deeply with everyone in the room.

The problem is that most of us are not living in a village anymore. We might have family a few streets away. We might have friends we catch up with on weekends. But the kind of daily, practical, show up without being asked support that used to exist in the communities our parents and grandparents grew up in has largely disappeared.

There is a real cultural contrast at play here. As Eddie described it, back in a Lebanese village, when someone had a baby the whole village had the baby. There was knowledge, there were people, there was presence. You were surrounded. Here in Australia, in an individualistic society, that same person is expected to manage a new baby, her own recovery, a household and often a job, largely on her own.

In place of the village, the mental load falls on the mother. She manages the house, the children, the emotional labour and the invisible administration of family life, often while also working. And when she struggles, the responses from the people around her tend to be well meaning but completely missing what she actually needs.

The village is not just a nice idea from a different era. It is a mental health strategy. When women do not have access to genuine community and support, the consequences show up in ways that are very hard to reverse.

Postnatal Depression: When the Dark Hole Has No Exit

Postnatal depression is not the same as the baby blues. Most new mothers experience a period of emotional adjustment in the first weeks after birth. Postnatal depression is something different. It is deeper, longer lasting, and in serious cases it puts both the mother and the baby at risk.

Dr. Marie Rose Mouawad described women who come to her presenting with what looks like a routine six week check, and as the conversation unfolds it becomes clear they are not okay. They are in a dark hole and they do not know how to get out.

Dr. Michael Azzi also raised that postnatal depression is not always purely psychological in its origin. Research through NaPro has shown hormonal contributions to postnatal depression that can be investigated and treated. This matters because it means that for some women, postnatal depression is not about being stronger or more grateful. There is a biological dimension that deserves medical attention.

Teresa Centre was created partly to fill this gap. Trained volunteers accompany women through the postnatal period, and professional referrals are available when the situation requires more than a listening ear. The message is consistent: you do not have to find your way out alone.

Menopause: The Mental Health Story Nobody Tells

Hot flushes. Night sweats. Mood swings. Most people know the physical symptoms of menopause. What they often do not know is the mental health dimension that sits underneath all of it.

Perimenopause, the phase that precedes menopause, can bring irregular periods, heavier or lighter bleeding and a range of symptoms that many women initially dismiss or misattribute to stress or ageing. By the time a woman reaches menopause itself, she may have been managing these changes for years without a clear framework for understanding what is happening in her body.

Dr. Marie Rose Mouawad completed additional training in menopause specifically because she felt she was not equipped to help her patients through it. What she found was a conversation that most healthcare appointments are too short to have. The period stops. Hormone replacement therapy is prescribed where appropriate. And the deeper experience of what a woman is going through emotionally during this transition is rarely explored.

Depression, anxiety, a sense of losing control, and a feeling of not knowing what is happening to you: these are not personality changes. They are symptoms of a significant hormonal shift that the body is working through over the course of years, not weeks.

“I don’t know what’s happening to me.” — A common experience among women in perimenopause and menopause, as described by Dr. Marie Rose Mouawad

What Husbands and Partners Need to Know

Eddie raised this question directly in the episode, partly from personal experience. He nearly froze during winter because his wife was getting hot flushes and kept removing the blankets. He understood intellectually what was happening. But understanding and truly knowing what to do with that understanding are two different things.

Both Dr. Michael Azzi and Dr. Marie Rose Mouawad gave the same core advice: come to the appointment. Sit with your wife or partner. Ask her to explain what she is going through. Be present for the conversation rather than waiting for it to be over.

Menopause is not a quick fix. It can take years. The support required is long term, patient and practical. She is not going crazy. This is real. And it is temporary.

The Human Connection ChatGPT Cannot Replace

There is a temptation in our current moment to reach for technology when things get hard. You can ask ChatGPT about miscarriage symptoms. You can search for postnatal depression tests at midnight. You can find a menopause forum at two in the morning when you cannot sleep and you do not want to wake anyone up.

But as Dr. Michael Azzi put it simply in the episode, technology is not going to provide long term support. It does not know who you are. It cannot sit with you in the grief of a pregnancy loss or hold the complexity of what a high risk pregnancy feels like from the inside.

The answer, then and now, is other people. Real people. A doctor you trust. A friend who has been through it. A centre like Teresa Centre where someone will walk alongside you without judgment. The village you build deliberately, because the one that used to exist has largely gone.

Finding Your Sanctuary

Whether you are navigating fertility struggles, carrying the weight of a difficult pregnancy, working through postnatal depression or stepping into the unfamiliar territory of menopause, the message from this episode is clear.

You were not designed to do this alone. Asking for help is not failure. It is courage. It is the village working exactly as it should.

If this episode resonated with you, share it with someone who needs to hear it. And if you are looking for a community that holds space for conversations like this one, come and find us at hshl.org.au.