How to Survive the Unspoken Grief that Comes After Miscarriage
“I would have had my baby in one more month, but at four months pregnant, I lost him,” says one mom. “I was feeling fine, but at my regular appointment the doctor couldn’t find a heartbeat. I don’t understand what happened. I’m devastated but I don’t know what to do.”
“I’m 38 weeks pregnant, and I found out today that my baby is gone,” says another. “I could feel something wasn’t right. She wasn’t moving as much, and sure enough, at my appointment, they couldn’t find a heartbeat. I don’t know what I’ve done wrong.”
“I was only 12 weeks along when the cramping and spotting began,” says mom number three. “Later, the contractions began and the pain grew intense. I went to the emergency room, and soon I was bleeding everywhere. A blood test and ultrasound confirmed what we already knew. How do you get past this feeling so you can think about another pregnancy?”
These are just a few statements expressed by women who have suffered miscarriages. The March of Dimes states that about 10–15 out of 100 pregnancies end in miscarriages, but there may be more, because sometimes the baby is lost before a woman knows she’s pregnant.
There are all sorts of medical reasons why miscarriages happen, but sometimes there seems to be no reason at all. Women can work with their doctors to try to figure it out, but what is usually most difficult is dealing with the emotional aftermath. Grief, depression, and even post-traumatic stress disorder (PTSD) are possible, and then there’s the whole question of “should we try again?”
Worse, many women don’t feel like they have anyone that they can talk to. Miscarriage is a very personal experience, and often women feel like they’re just supposed to “get over it” and move on.
“No one wanted to say that dirty word to me,” says mom Ann Zamudio. “I got looks of sympathy, quickly administered hugs and flowers….No one said it outright, but the message was clear: it was time to suck it up and put this ‘business’ behind us.”
Many women feel the same, but doctors and scientists say that shoving the emotions down is not the right way to deal with them.
What is a Miscarriage?
A miscarriage occurs when for some reason, there is a loss of the fetus before it is “viable.” A viable fetus is one that would have had the potential to survive outside the womb, which in the United States, is defined as the 20th week of pregnancy.
Doctors call a miscarriage a “spontaneous abortion,” which of course makes a lot of women feel worse. Neither term is comforting, with “miscarriage” implying that a woman didn’t “carry” the baby right, that somehow she did something wrong to “miscarry.”
The truth is, however, that miscarriage is one of the most common complications that can occur in early pregnancy, and it certainly isn’t the mother’s fault. Sometimes there are symptoms, but other times it can happen without the mom knowing. If there are symptoms, they often include:
- Pain and cramping
- Spotting and bleeding
- Feeling faint or light-headed
- Fluid and/or tissue discharge from the vagina
There are numerous reasons why a miscarriage might occur. If there are problems in the placenta, womb, or cervix, it can happen. If there are chromosome abnormalities, or if the mom has polycystic ovary syndrome, it may happen. Other health issues like kidney disease, diabetes, thyroid problems, high blood pressure, and more can all affect risk. And if a woman smokes, drinks alcohol, or uses illegal drugs, she increases her likelihood of a miscarriage.
Sometimes, though, even if a woman is perfectly healthy, a miscarriage can happen for no known reason. While it’s important for women to do everything they can to ensure a healthy pregnancy—eat right, exercise, avoid smoking and alcohol, and have regular medical checkups—it’s often even more important to address the emotional issues that miscarriage creates. If they are left to fester, they can affect a woman’s mental and emotional well-being far into the future, even if she goes on to experience one or more successful pregnancies.
How Miscarriage Increases Risk of Depression, Anxiety, and Other Psychological Challenges
While women may understand that miscarriage is common, and may imagine that they can get through it on their own, the truth is that it is a very traumatic experience that requires careful attention.
That’s because miscarriage increases the risk of a number of psychiatric problems. According to a 2008 study, drug and alcohol problems and psychiatric disorders are more likely in women who have suffered from a miscarriage or an abortion.
“We found that young women having a miscarriage or an abortion were three times more likely to experience a drug or alcohol problem during their lifetime,” said lead study author Kaeleen Dingle.
A later 2015 study found that miscarriage increases risk of depression and anxiety. Researchers found that nearly 20 percent of women who experience a miscarriage develop symptoms of depression and/or anxiety, and in most cases, those symptoms persist for one to three years—even if the women experience successful pregnancies during that time.
It doesn’t help that many women feel alone in their grief. “Contributing to the distress experienced after miscarriage is the fact that society may not recognize the significance of the loss to the parents,” researchers wrote. “Traditionally when a death occurs, families are able to openly mourn their loss and receive support for many months. However, in miscarriage, the loss is sudden and often unexpected, and women may not have shared the fact that they were pregnant, leaving them to grieve alone, socially isolated.”
The researchers go on to note that the mental and emotional impact of miscarriage is sometimes overlooked because miscarriage is so common: “Although 90% of women desired specific follow-up care from their physician, only 30% of them received such attention.”
In many cases, doctors lack the training they need to deal with these issues. They may not even realize that women need psychological attention, and just focus on physical health issues instead.
This often leaves women on their own to seek out treatment. Yet women are often unaware of just how much trauma they’re going through. Janet Jaffe, Ph.D., clinical psychologist and author of the book, Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients, told the American Psychological Association (APA) that it’s not only about losing the child:
“[M]iscarriage is a traumatic loss,” she said, “not only of the pregnancy, but of a woman’s sense of self and her hops and dreams and future. She has lost her ‘reproductive story,’ and it needs to be grieved.”
6 Steps to Help You Deal with Miscarriage Grief and Trauma
No matter what your doctor, family, friends, or anyone else says, if you’re a woman who has suffered a miscarriage, it’s important to be aware of the seriousness of what you’re going through.
Realize that you will probably have to take responsibility for your own recovery, which means reaching out. That may be hard for you to do, but it’s vitally important to your health and well-being, and to your ability to go on and enjoy the rest of your life.
The following seven steps will help:
1. See a counselor.
The most important thing you can do after a miscarriage is to talk about it. Unfortunately, in our culture today, you may not feel like you can do that. Realize that it is key to your recovery. Ask your doctor for recommendations of a counselor that has experience with miscarriages.
Even if you think you’re doing “fine,” make an appointment with a trained psychiatrist. The right person can help you examine what you may be feeling, and give you techniques to help you cope.
2. Join a support group.
Ask your doctor for a miscarriage support group in your area. Talking to other moms face-to-face can help you feel less alone, and give you a place to share your feelings with other people who really understand.
You can also try online support groups, though it’s best if you use these in addition to your face-to-face group rather than instead of. The nice thing about online groups is that they provide anonymity, and they are available at all times of the day and night.
3. Don’t blame yourself.
Most women go through some period of self-blame. They may feel guilty or worry that they did something wrong.
“I think it’s almost a rule that there’s self-blame,” Zevs Williams, director of the Program for Early and Recurrent Pregnancy Loss at the Albert Einstein College of Medicine in New York, told the Houston Chronicle. “It almost invariably happens that they think back to everything they did the week leading up to the miscarriage and blame themselves.
In Williams study on miscarriage, nearly half of respondents who had miscarried reported feeling guilty, and 41 percent thought they’d done something wrong.
Jaffe also acknowledges that women often blame themselves, even when they did everything “right,” tormenting themselves with guilt and blame, and this only makes it less likely that they will be able to recover.
Realize that these feelings are normal, but they are incorrect. Miscarriages happen for a number of reasons, such as those listed above, and the majority of these have nothing to do with a mom’s behavior prior to the event.
Allow yourself to feel your guilty feelings, but then journal about them or talk about them with your counselor so you can work through them. Otherwise, you will likely carry them around far too long. The goal is to completely forgive yourself, even when there is nothing to forgive.
4. Acknowledge your loss with a ritual.
When we lose someone in our lives, there are rituals to help us process our grief. We attend funerals, we go through the burial, we sort belongings, and we put up some pictures and take down others.
With a miscarriage, however, many of these rituals don’t take place. There is no body so there may be no funeral, no burial, no family gathering. This can make the process even more difficult.
It can be helpful, then, to create your own rituals to help you grieve. You can write a letter to your unborn child, and even take out a burial lot if you like and create a stone. You can hold a private ceremony at your church or other location, or gather together with family and friends for a honorary meal.
Many people create altars that they then place on a shelf or windowsill, or even in the garden. Some create jewelry or art, compose a unique piece of music, or create a website or foundation in the memory of their baby.
You can perform these sorts of rituals at any time. Use them to help yourself to process your emotions, and to give your child the place he or she deserves in the story of your life.
5. Realize it takes time.
There is no time limit on grief. It’s a mistake to expect that you’ll be “back to normal” in a month, or two months, or four months. Try not to rush yourself.
At the same time, continue to take steps to help yourself heal. Continue to talk to a counselor, attend your support group, journal about your feelings, take part in your rituals, and forgive yourself. You will likely need to do these things over and over again before the pain will gradually start to ease.
Eat good food and take daily walks. Honor your grief, and soon you will feel like you’re ready to move forward again.
6. Open yourself up to helping another woman.
One of the things that is most helpful to a woman who has gone through a miscarriage (or more than one) is helping another woman who is going through it. You have valuable experience to share that can be extremely helpful for someone who just got the devastating news.
Extending yourself for someone else can also help you feel that at least your experience came to some good. You have knowledge you can now pass on, a strong shoulder you can offer another, and a broken heart that can truly understand. It may take some time before you can get to this point, but when it happens, it will help diminish your pain just a little—and sometimes, that’s enough.
“Miscarriage,” March of Dimes, http://www.marchofdimes.org/complications/miscarriage.aspx.
Ann Zamudio, “Why Don’t People Talk About Miscarriage?” ScaryMommy.com, http://www.scarymommy.com/talk-about-miscarriage/.
“Abortion and Miscarriage Bring Psychiatric Risk,” University of Queensland, [Adapted Press Release}, MedicalNewsToday, December 22, 2008; http://www.medicalnewstoday.com/releases/133560.php.
Johnna Nynas, et al., “Depression and Anxiety Following Early Pregnancy Loss: Recommendations for Primary Care Providers,” Prim Care Companion CNS Discord. 2015; 17(1): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468887/.
Elizabeth Leis-Newman, “Miscarriage and Loss: Losing a pregnancy can affect a woman—and her family—for years, research finds,” Monitor on Psychology, June 2012; 43(6):56, http://www.apa.org/monitor/2012/06/miscarriage.aspx.
Maggie Gordon, “Why don’t we talk about miscarriages?” Houston Chronicle, April 1, 2016, http://www.houstonchronicle.com/life/article/Why-don-t-we-talk-about-miscarriages-7223341.php.