I will deal with the physical ramifications of miscarriage in a future post. In this article, however, I want to specifically discuss a range of topics regarding the emotional impact of pregnancy loss.
Miscarriage Is More Common Than You Might Assume
It is very important for mothers who have lost their children to know they are not alone. In fact, approximately 15-20% of confirmed pregnancies end in miscarriage. That’s 1 in every 5 to 6 pregnancies. And, that doesn’t even account for the pregnancies lost when the mother wasn’t even aware she was pregnant.
It’s A Unique Form Of Loss
Having a miscarriage is a very unique form of loss. It’s very different from the grieving process associated with, say, an elderly person who has passed away.
With pregnancy loss, the grief tends to be for a person you never knew and a relationship that ended before it really began. There also tends to be grief surrounding the hopes, plans, and dreams you had for your baby and your family. Plus, there is a grief surrounding a particular future that will never come to be.
What Feelings Might You Experience?
Losing a pregnancy can be devastating, and it’s actually normal to experience a gamut of emotions.
You may feel any of the following:
While feeling guilty is normal, try to keep in mind that most miscarriages happen for no reason and it’s very unlikely that it happened based on anything you did or didn’t do.
Anger is normal. It might be with yourself, with a higher power, and even with those close to you. You might also feel anger toward others who are pregnant or who have had a baby.
The sorrow might feel overwhelming. Many women report crying more than ever before in their lives. There can also be a feeling of emptiness.
Many people go on a desperate search for answers. Why did it happen? Why did it happen to you? Unfortunately, for most miscarriages, a cause can’t be found.
Grief can often manifest similar to fear. You may feel sick or feel like you have butterflies in your stomach.
Some people experience withdrawal and a lack of feeling “alive”.
You may feel tired, but unable to sleep. Or you may want to sleep all the time.
How Long Does The Grieving Process Last?
Make no mistake…losing a pregnancy requires a mourning process. The same grieving cycle that accompanies other deaths tends to apply (denial, anger, bargaining, depression, and acceptance).
The grieving process can last anywhere from less than a month to more than a year. Generally the feelings are intense and all-encompassing at the beginning but tend to ease up and give way to periods of relative well-being and eventually acceptance as more time goes by.
A more important point, however, is that there is no set rule-book for the mourning process. Everyone is different. Some women are able to move through the loss quickly, while others feel deep despair for a long time. Either way, honor your own feelings. Either reaction, or anything in between, is appropriate.
Additionally, some people can feel depressed after a miscarriage even if they were ambivalent about keeping the pregnancy in the first place. It’s still a major loss.
When Is It More Than Just “Normal” Grief?
That’s a very important question.
Keep in mind that the main risk factor for post-partum depression is being pregnant, so even if the pregnancy ended in miscarriage, it’s still possible you could be suffering from post-partum depression or anxiety. After all, any time your body goes from being pregnant to not being pregnant, there is a significant shift in hormones that can affect brain chemistry.
“Healthy” grief moves, but sometimes it can develop into relentless depression that requires more specific treatment. If you’re having any doubt at all, please reach out for professional help.
Dealing With Guilt
I mentioned feeling guilty above, but I wanted to expand on it a bit here because it tends to be common for most women. In fact, some women experience this as a failure in their primary role as a woman.
An important thought, however, is that miscarriage is something that happened to you, NOT something you did. For the most part, biology is in control and women are along for the ride. And, again, miscarriage is far more common than most people think it is.
Finally, consider this. If a friend had a miscarriage, would you tell them to blame themselves? Of course not. So don’t treat yourself that way.
Moving On Does NOT Mean Forgotten
This concept is an offshoot of guilty feelings. At some point, you will feel whole again and you will feel ready to move forward in your life. That’s great. You deserve to be well!
Just know that “moving on” does not mean forgetting. Your pregnancy, the baby you lost, and what “might have been” will always be a part of you.
It Is Normal To Get “Triggered”
It is normal to feel triggered into sadness when you least expect it. You might get set off by seeing other pregnant women or other babies. You might feel sadness at certain holidays or anniversaries. Sometimes even an ad on TV might trigger tears. Just know this is completely normal and part of the process.
Dealing With Others
Many people don’t realize how major a pregnancy loss is and may say things like “Don’t worry…you can always try again” or “You”ll have better luck next time”. Generally, these people don’t mean to be insensitive. They are unaware how profound your pain is. Try not to take their well-intentioned comments too personally.
Additionally, people don’t always know what to say. Some people will walk on eggshells trying to avoid the topic. Others might pry too deeply. It’s helpful to be direct and let the people in your life know what you need.
Dealing With Your Partner’s Feelings
Your relationship with your partner will be impacted. It’s very important not to isolate each other. Part of that is understanding that your partner is a different person and will experience this loss different than you will.
First, the bond between a pregnant woman and the baby growing inside of her is unique. That bonding tends to begin the moment she learns she is pregnant. Your partner can’t possibly have had the same experience as you, so don’t expect them to.
Plus, men and women tend to process miscarriage differently. While women tend to be more expressive about their feelings, men can have a tendency to try to problem-solve and try to find solutions to make you feel better. Understand that this doesn’t mean he’s not grieving…he’s just experiencing things differently.
As always, open communication within the relationship is key.
Is It Possible To Have A Healthy Pregnancy “Next Time”?
Yes. In fact, you’re much more likely to have a healthy pregnancy than another loss. Statistically, most miscarriages are a one-off event.
Your chances of having a healthy baby may even be good if you have had recurrent miscarriages (3 or more). In fact, 75% of women who have had normal test results after recurrent miscarriages go on to have a healthy baby. So, unless your doctor tells you otherwise, your next pregnancy is more likely than not to go smoothly.
Emotionally, “Next Time” Can Be A Little More Challenging
While the statistics above should be encouraging, they are just the physical side of the coin. Emotionally, there tend to be more hurdles to overcome.
While doctors typically advise giving your body the chance to have 2 or 3 periods before trying again, it’s also essential to wait until both you and your partner have worked through the emotions of the loss, perhaps with professional help.
Once you are pregnant, having a anxiety is perfectly normal and understandable. Many women report this time as being the longest 9 months of their lives.
Many people will likely tell you that your anxiety will improve once you get past the date of your prior miscarriage. For some that’s true. However, everyone is different, and that’s not always the case.
As difficult as it may be, try your best to stay positive, as chances are you will have a normal pregnancy? Additionally, speak with your doctor. There are often early tests and scans that can help reassure you. And, your doctor can help devise a plan to help support you through this period of time.
HOW CAN I HELP?
As mentioned above, the emotional impact of miscarriage can be enormous, and it can be overwhelming. Additionally, it can lead to depression, anxiety, bipolar exacerbation, grief, and despair.
Each woman has individual and specialized needs. Talking to someone who understands what you’re facing and what you’re trying to achieve can help significantly. I highly recommend working with a specialist in Reproductive Psychiatry in concert with your Reproductive Endocrinologist.
I am one of only a handful of Psychiatrists in the United States specializing in this new and under-served field of care. If you live in the New York City area, I’m heer to help you with compassionate and professional care, as well as the most up-to-date treatment options.
Please phone me at 917-609-4990 to arrange a consultation.
For additional information about this topic, or for help finding a specialist in your particular area, please email me at Amanda.firstname.lastname@example.org.
Dr. Amanda Itzkoff