Grief Issues Special to Miscarriage

As we women regard our foetus’ as part of ourselves, miscarriage is a complex grief that leaves us particularly vulnerable and involves a number of other potential significant losses and additional suffering which is not necessarily present with other types of bereavement, except a stillbirth which is a similar loss occurring after 20 weeks. Not only have we lost our baby, we are suffering from the effects of both a birth and a death. Miscarriage is unique (unless someone has disappeared) in that we have very little remains to bury, sometimes because no baby has formed properly or it is unfortunately passed when using the toilet. When this happens, or even with a later miscarriage and an identifiable little body, our loss can be minimised and invalidated by others, which leads us to question our feelings of grief. However, unrecognised or not, it is the strength of the bond with our baby not the length of the pregnancy that determines the depth of our grief. This mothering bond can have begun to form as early as us playing with our dolls as little girls, so our grief is a normal reaction to a broken bond.

For recurrent miscarriers, grief will usually be compounded by their previous loss/es. For those women who require ‘reproductive technology’ (IVF) to conceive, researchers at the University of Hong Kong have found they are more likely to experience trauma. The emotionally draining toll from prolonged infertility, the physically invasive conception process, the associated psychological issues and the uncertainty of a successful pregnancy even with help, stretches women’s coping skills. This can result in anxiety and depression and may also remain longer than for others who conceive naturally. (We think that would also depend on each individual and their life experiences and the number of losses they had experienced.) The good news is that Otago University researchers have discovered there is a switch in the brain that actually turns fertility off and on. They hope to be able to control it with-in 5 years.

A funeral normally gives people their cue of how to behave appropriately with protocols to follow and when there isn’t one others are often at a loss themselves and may not even realise we are grieving. This adds to our stress as we can then feel we need to explain this, whereas with a still-birth or loss of a child, everyone is aware of the devastation and expects us to grieve. People may not want to talk about what has happened perhaps because of their discomfort with the issue of death, and it’s the only thing we can think of. This leaves us open to well meaning platitudes or disbelief that we are grieving. (For people who have no experience of miscarriage, we recommend they look up our seven things ‘To say and do‘ and also ‘Not to say and do’.)

Because miscarriage is such an ambiguous loss, the other losses along with it are more difficult to explain unless the person has had a miscarriage themselves, which is why talking to someone who has had one, can offer the most comfort and empathy. This can be a grandmother, mother, sister, friend, medical professional and even sometimes, unexpectedly, a woman who is perhaps only an acquaintance or even a stranger (as on a bulletin board) because they understand the feelings and possible losses involved like –

  • the loss and the feeling of being cheated of the joyful experience of pregnancy and birth and possibly future ones and also the festivities around that
  • the loss of our dreams for this child and the future our family would have had together – we had made plans for life
  • the loss of being able to call ourselves a mother (if no previous pregnancies)
  • the loss of access to successful womanhood (in our own or others eyes)
  • the loss of trust in the body we feel has betrayed us
  • the actual physical loss and the fear that can be felt from the amount of blood passed
  • the confusion and dismay when experiencing a ‘blighted ovum’ when there is only an empty sac
  • the loss of innocence for future pregnancies
  • the loss of the belief system we didn’t even necessarily recognise we held that says “this won’t happen to me”
  • the loss of our basic trust in life and the fear and insecurity of a less predictable world
  • the loss of control over our expectations of life
  • the loss of the achievement of a goal we had set for ourselves (this may not have been experienced before)
  • the loss of self-confidence
  • the loss of control of our feelings
  • the threat of loss of our identity
  • the failure to reproduce when the body is giving monthly signals of fertility
  • the illogical but real sense of shame, guilt or embarrassment
  • the worries or fears that this amount of grief (over what is often seen as a minor blip in life) cannot be normal
  • the feeling we should hide our loss and not talk about it as others think we are over-reacting
  • to be unable to do what other women seem easily able to do as a ‘natural part of life’ and our jealousy, envy, anger and sometimes bitterness of that
  • the loss or change in relationships (sometimes permanently) as we experience others lack of understanding and the isolation and loneliness this causes
  • dealing with others’ inappropriate comments, some with the best of intentions
  • dealing with the thoughtless attitude of others, who have children without experiencing problems, which can be complacent, smug or pitying (perhaps unintentionally)
  • dealing with our feelings over others’ pregnancies (relatives being even more difficult), especially when they are due around the time we would have been and then later their new babies
  • our strong reaction when we observe children being mistreated, feeling how precious they would be to us
  • the ‘what ifs’ or ‘if onlys’ that may result from us not even knowing we were pregnant
  • the thought that we didn’t love our baby enough to keep it alive
  • the thought that we have somehow killed our baby, or we did something wrong
  • the thought that our body failed both of us – my body – I failed
  • the thought that only 1 heart beats in my body again
  • the longing for our baby not to be taken away with a D&C even when we know he or she is dead
  • the difficulty in understanding how hard it is to miss someone we have never met
  • the difficulty adjusting back to normal life again, missing not having to be consciously aware of things that may affect our baby; like what we eat or drink and the limitations we may have put on physical movement
  • the loss of our last chance of having a child because of our age
  • the loss of our last chance to conceive because of the inability to pay or be eligible for further IVF treatment
  • the feeling we have let our partner/others down
  • the guilt and confusion if we have previously had an abortion
  • the feelings of guilt and regret and that we deserved to lose our baby because we even considered an abortion, although we didn’t go ahead
  • the sometimes harsh judgments we make about ourselves
  • the feeling of being emotionally crippled
  • the little anticipation of grieving when the miscarriage happens very suddenly with no warning
  • the pain of not knowing the baby’s sex
  • the pain of not ever knowing the cause of loss
  • that miscarriage is a grief with no picture memories and so few others
  • no answer to why, means blaming ourselves
  • continuing to grieve for  – the lost possibilities – the unknown – even a glimpse of the mystery of our potential little human being

Living in a world where science has overcome many things, and especially in the health area, the parents-to-be can be shocked and dismayed to find that there are no straight-forward answers to miscarriage from the health professionals. Sometimes their pragmatic attitude to miscarriage can be very hurtful. Using insensitive language and referring to the baby as ‘clots’, ‘tissue’, ‘products’, ‘foetus’, ‘termination’ and their use of the medical term ‘abortion’ in conjunction with a ‘miscarriage’ seems harsh and judge-mental to us. A miscarriage can be seen as a minor medical occurrence by them and the grief that it can generate is not always understood. We have found that women heal more quickly when they experience an understanding and empathetic attitude from their medical LMC.

In this century with the expectation of ‘instant everything’ and ‘women can do it!’ along with perhaps not experiencing anyone’s death previously, there is also not the sense of acceptance and resignation of life’s realities as in other times, which could help with the acceptance of loss.

“It seems to me that women do not exactly go looking for sympathy, more a recognition that a loss from Miscarriage is felt as keenly as any other.”

Pro-creation is a primal basic function inherent in all human beings so it is normal to have strong feelings about sex, pregnancy and birth and an innate mothering instinct that sometimes can be beyond reason and control. It is a natural part of living and no shame or embarrassment should be attached to how we feel after the loss of a baby at whatever stage of their development. (Dr. Diana Bianchi – re white blood cells from any pregnancy left in a mother’s body.) As women (certainly in New Zealand) now have their children later, average age 30 years, and their genetic signals intensify, they become aware of their biological clock ticking (DEL), so their reaction to loss can be stronger.

Women are born with about 2 million eggs although only about 400 of these will be released in our lifetime. Something many women are not aware of is that, the perfection of these eggs decreases with a woman’s age beginning at approximately 27 and from 35 years on, the rate of decline accelerates. This leads to a higher rate of pregnancy loss and can also create problems even if the baby is carried to full term. Women can feel pressured (by themselves or others) to try again quickly, often not taking the time to allow the grief from their miscarriage to pass (3 to 6 months is a guideline). This can have consequences such as partnership stress and/or post-natal depression later following a successful pregnancy.

Women are always looking for answers to ‘why’ and, although there are reasons, they do not usually find out what they are, so miscarriage grief is not so much about finding the answer they yearn for, as learning how to live without one.

“I kept trying to find something that would assure me that the relentless despair I was experiencing was anywhere close to being normal.”

“Look, I want to feel better but I’m never going to ‘get over’ my miscarriages. I know that someday, I’ll feel better and it won’t hurt so much but I’m never going to forget those babies I lost and I don’t want to.”

Bella Online