grief feelings in general

Grief is a normal, healthy and appropriate response to a miscarriage but that may not seem so to all people we come in contact with.

Although over 70% of women perceive that a baby is lost when a miscarriage happens, society in general does not necessarily believe that, so miscarriage is seldom acknowledged or talked about much. No miscarriage should be taken lightly, by our-selves or the community. It is a sad commentary on any society and its ignorance that when we miscarry, instead of receiving sympathy and support, we can be made to feel that losing our baby is somehow our own fault. Recurrent miscarriers even more so.

People do have difficulty understanding what may have never been seen, heard, smelled or touched even existed and can refuse to acknowledge the possibility that it was a baby. There seems to be no universal agreement for when a soul enters a body either mainly because widely held fundamental beliefs vary and consequently for when a foetus becomes a baby. Unfortunately the key to recognising a little life lost is dependent on an acceptable community definition. A stillbirth (in NZ that means that the baby is born after 20 weeks gestation) is far easier to acknowledge as a baby with a soul, even though a miscarriage may have happened only one day earlier and there is a discernable body. That there are a no legal requirements for miscarriage like a birth or death certificate, and no obituary notice, no memorial service, no funeral formalities and often no body to bury anyway, it tends to signify that a baby never existed.

Even though up to 70% of miscarriages are due to chromosomal abnormalities and no-one’s fault, this is not generally known, so with no apparent meaningful explanations about the cause of a miscarriage, conscious or subconscious thoughts can result in a cultural ambivalence and the sometimes judgemental attitude of ‘women can control the outcome of their pregnancy by abiding by the rules e.g. non smoking, non drinking, choosing correct foods etc.’ Unfortunately, when that happens and we buy into this attitude ourselves, aside from it adding to our already guilty feelings and re-enforcing them, it makes it easy for others to continue with that point of view.

Meaningful and descriptive words such as a ‘premature stillbirth’ or ‘early stillbirth’ would be more useful too than the word ‘miscarriage’, which is associated with the legal, ‘miscarriage of justice’ phrase. This can link fault in people’s minds with the tendency to blame the mother again. There is little automatic assumption that the father could be part of the problem but research shows that men often are. (see Causes)

Nor is it always accepted that for most women and their partners, the loss will be followed by a period of grieving, even though it is more meaningful in the woman’s case, although may not cut in for several weeks. (The parents could have already seen their baby on an early scan showing a tiny beating heart and, if the miscarriage occurs later in the pregnancy, it can also mean the mother felt the new life move inside her.)

When grieving is not acknowledged and validated by the community, the subsequent feelings can remain unresolved, becoming disenfranchised grief and cause serious relationship and mental health problems. For the woman, depression is not uncommon and there is also a tendency for them to think the emotions they are experiencing are somehow wrong and also trivialize it themselves. They may also expect (or be expected to) not to feel too bad when they have other children. It does not make any difference. The grief is for this lost baby and the difference it would have made in everyone’s lives. The grief can be so stressful that many women in fact wonder if they are going mad.

Personal

If this is your first miscarriage, which you may have only heard referred to peripherally, you could be bewildered by the devastation and intensity of your feelings and be in a state of disbelief, thinking to yourself ‘Babies aren’t supposed to die’. The loss of a baby undermines our most fundamental human need to reproduce so the grief you are feeling is serious; it affects us in so many ways we don’t even realise (see ‘Grief issues special to miscarriage’). The pain of grief is caused by losing someone we have begun to love. Bonding with your baby will have already started and the stronger the bond, the deeper the pain. Studies show that the mother usually begins bonding with the baby from very early pregnancy, although many of us weren't even aware of it, so the depth of this grief can be shocking. It is generally experienced sequentially in three stages; the psychological shock and intellectual stage – in the head; the longest is the emotional and suffering stage – in the heart; the physical reconciliation and recovery stage – in the gut; and overall we are usually spiritually affected.

But your feelings at any time may fluctuate and include one or more of the following: shock, confusion, denial, anger, guilt, jealousy, shame, numbness, depression, frustration and unreality. Some women may not feel any of this at all or at least a milder version, or it may happen weeks after the physical miscarriage. Sometimes the initial experience is a sense of surrealism and a clinical detachment when talking about the miscarriage and later embarrassment from unexpected behaviour like uncontrolled bouts of weeping or an unprovoked emotional outburst. Women at any stage can be surprised how strong their feelings are and how long they last, particularly those who had not planned their pregnancy or did not particularly want children. Although all these feelings are normal, healthy responses to the loss of a baby, the turmoil from them can and often does lead to emotional isolation as well.

Guilt is a common part of any grief, but in miscarriage it usually plays a much greater role. We want to reassure you that a miscarriage from a non-viable pregnancy i.e. chromosomal abnormalities that creates a fetus which is incompatible with life, causing the death of your baby, does not result from ordinary exercises like bending, stretching, walking, swimming, having sex or anything you inadvertently did or didn't do in normal daily activities. These 70% of miscarriages are inevitable and nothing could have been done to save the pregnancy. Some people feel their loss was a punishment from God, but this was an act of nature.

It is misdirected and counter productive to take on board guilt and blame yourself and it can delay a healthy recovery. Continuing to self blame leads you to also not seeing yourself as a potential mother. We all tend to want to blame some-one, especially when we don’t have answers. (See our list of ‘why miscarriages happen’ for other possible causes.)

Evading and avoiding our feelings by taking drugs, sedatives or alcohol are tactics we can use to prevent ourselves from feeling pain. While initially they seem to deaden it, they really just slow down the grieving process so that it drags on unnecessarily and/or suppresses it. However, if your health professional really feels that drugs are necessary, use them strictly in accordance with their instructions.

Unexpressed grief always has consequences, often in unrecognised ways. For instance, relationships tend to suffer and can lead to breakdown. As in all child loss, whole futures are affected which is really difficult to accept, unlike most deaths that are about the past. We have also come to the conclusion (as we have found other counsellors and organizations have too) that baby loss is at least part of post-natal depression after a subsequent pregnancy.

We may be surrounded by people who live in a culture of ‘grief denial’ but it is normal to grieve following a loss and grief is referred to as ‘the healing feeling’. You do not need anyone’s permission to grieve. Everybody reacts differently and we encourage you to accept your feelings whatever they are. They vary greatly for each of us.

Allow yourself to laugh sometimes when appropriate, as it is part of the healing process too, making the pain more bearable. It is helpful to join an online group, or a local group if there is one, or friends who have experienced miscarriage, for a sense of belonging and support to overcome the worst of the feelings of isolation. From our experience supporting women, a mentally healthy person should feel more like themselves by three to six months, albeit changed and perhaps with a deeper appreciation for life.

However you may wish to consider counselling if it is taking longer, or if at any stage you experience particular difficulties or feel obsessed by your loss, but especially if you have had recurrent miscarriages or other losses to compound your grief.

The following is a synopsis from research being done at Tufts University by Dr. Diana Bianchi that resonates with many of us who have lost babies and it confirms why we often feel our loss so strongly – ‘With each pregnancy, a woman is given fully functioning white blood cells from her child. Regardless of the outcome of the pregnancy, live or still, full term or miscarried, the mother is left with cells filled with the DNA of the child in her body. Cells that are fully working, in the brain even, that show up first on the site of infection or injury.’

Even when we are functioning on a reasonable level again and we think we have dealt with our grief feelings as they are no longer disrupting our lives and we allow ourselves to tentatively feel joy again, they can recur, especially around dates and other personal anniversaries. The healing scar is still fresh and the ‘what if’s’ are always there to be imagined.

Although grief healing means refocusing, it does not mean forgetting or making our memories insignificant. The bond formed can last forever, but the sorrow does dissipate over time and the memory becomes a part of our lives, diminishing in intensity when less sadness is experienced and there is more acceptance of our loss or losses. Most of us never forget our lost babies and don’t just ‘get over’ our longing and sadness; we will probably always feel that tiny, precious, secret place in our heart that aches. We can come to cherish that in a healthy way and recover and refocus again on normality.

A poem often quoted;