Ellen sat numbly in my office, the tears welling in her eyes seeming to hold the heaviness of her sorrow. She spoke haltingly, barely above a whisper. “Maybe if the baby had been born...had lived for a little while...others would feel the loss, and I wouldn’t be so alone. As it is now, it’s as if no one cares...or remembers...My mother, my husband...they’ve all moved on...Why can’t I?”
Miscarriage. The word itself evokes images of toppled dreams, and broken promises. For over one in five women this unintentional loss can happen any time in the first few months, although for most it occurs within the first several weeks of pregnancy. The reasons can be as unique as the pregnancies themselves, but usually miscarriages happen because biological abnormalities make it impossible for an embryo to survive. And once a miscarriage begins, there’s little that can be done to stop it.
But for Ellen and countless women like her, the logic of a medical explanation often provides little comfort. Whether the miscarriage happens early or later in a pregnancy, the one thing that remains consistent is that this loss can leave a woman feeling grief-stricken and alone. Reproductive science has made huge strides, allowing us a window on fetal life from its earliest stages. But ironically, there is no similar acknowledgment that the attachment a woman forms, along with powerful hormonal changes, can begin from the earliest days of pregnancy.
If infertility has been an issue, the grief of miscarriage poses an additional challenge. During fertility treatment, pregnancy is often perceived as the “brass ring” of success. When a miscarriage occurs under these circumstances, everything changes. Now moving forward in treatment can be filled with trepidation, born of the hard-won realization that what was extraordinarily wanted can sometimes be attained...and then lost. Women who suffer recurrent miscarriages probably know this lesson better than anyone else. But whether this is a woman’s first miscarriage or her fourth, it’s not unusual for her to try to distance herself from her grief. Yet this instinct to emotionally shut down will only prolong the pain. Grief is a process; it’s also a gateway through which you must pass to become whole again.
Honoring Your Grief after a Miscarriage
Many women are surprised by the shock and enormity of grief they experience after a miscarriage. But the truth is, no matter how early a miscarriage occurs, it is still a loss, and as such, it’s natural to be bombarded with a roller coaster of emotions: denial, anger, sadness, guilt. There may also be physical symptoms, such as loss of appetite, difficulty sleeping and concentrating, episodes of crying. It is so important to be patient with yourself, and allow yourself the time to work though these feelings and grieve this loss. Listen to your spirit and the way it needs to heal. For example, for a while after your miscarriage you may find that you need to avoid child-centered celebrations. You may notice that you need to slow down and cut back on your commitments.
Create space in your world to process your grief. Make time to sit with your feelings each day; you may want to process them by putting words to paper. Seek out support from those around you. If you have family and friends that can be there, reach out. If not, there are miscarriage support groups you can find in your community, or on the web. If you’ve been undergoing fertility treatment, and are involved in a support group, returning there can provide you with the comfort you need. Seek counseling if you find that you’re struggling to move forward.
Even though grieving a miscarriage is hard work that only you can do, don’t feel that you have to do it alone. Sharing your grief with others who can be there for you fills the critical need to be acknowledged, and supports you in finding your way to accepting the pregnancy loss.
After a Miscarriage: Understanding the Feelings of Those Around You
So often, when a loss feels devastating, it’s hard to imagine that others don’t experience it in the same way. But the simple truth is, even those closest to you may see things differently. You and your husband, for example, may have your own unique ways to express your grief over a miscarriage. In general, men are more action-oriented, like to focus on facts, solve problems. Because of this, you may notice that even though you might need to talk about your feelings, he may benefit from knowing specific ways he can help you, or he might be anxious to get back to work as a way of moving forward. Also consider that, if the miscarriage happened early on, the pregnancy may have been more intangible to him; he may not have shared the same emotional bond, although his grief can be just as real. Differences in intimacy needs may also need to be addressed as one of you may see it as a bridge to reconnection, while the other may recoil at its mere suggestion. Talking allows you to understand each other, and in acknowledging your differences, opens the possibility of growing closer through this shared loss.
If you have other children, take the time to tell them about what has happened in a language they can understand. Children naturally express their feelings in a variety of ways, such as drawing pictures or telling stories. Encourage this, and let them know that all their feelings are okay. If they blame themselves or express any concerns about their own mortality, reassure them. Give them the extra attention they need to feel safe.
As for others in your world, be prepared that even the most well-intentioned may unwittingly say insensitive things after a miscarriage. You may hear cliches like, “it’s for the best,“ or “you’re lucky it happened early in your pregnancy.” People may share their own loss stories or suggest you have another baby “so you can get over it.” Then there are those who will try and avoid the entire situation for fear that they are intruding, or out of concern that they may say the wrong thing. And, of course, there may be those who, without a reference of their own, don’t consider this a loss at all, and may try to diminish your sadness. Whatever the situation, remember to keep your expectations in check. Let those close to you know that this pregnancy, and its loss, was important, and perhaps ask them just to listen.
When you feel ready, consider what would be a meaningful way to honor this chapter in your life. A private ritual of some kind can be a way to say goodbye and help you to take the next step in your life. One couple I worked with planted a special tree as part of a ceremony, while they each shared the dreams they had for this child. Another woman I know wears a special piece of jewelry she purchased after her miscarriage, bearing the birthstone of the month when the child was due to be born. Remember also that this due date may be particularly difficult, and even if you’ve been feeling better, grief may return. Anticipate what might help you though the day, perhaps spending special time with your partner, or acknowledging this memory in some way.
The Circle Continues: The Courage to Try Getting Pregnant Again
The decision of when to try getting pregnant again is a deeply personal one that—aside from your doctor’s clearance—only you and your partner can make. There are some women who, shortly after a miscarriage, have a strong desire to get pregnant again; for them, this desire is healing. It is critical, however, that you do not rush headlong into another pregnancy or fertility treatment cycle while you are still actively grieving, hoping that this will erase the pain of this loss.
Instead, acknowledge that the choice to try again is a courageous one, as there may well be some challenges. It is likely that you’ll feel more vulnerable this time around, more sensitized from your past experience. You may even hesitate at first to bond with this new pregnancy for fear that you'll have another miscarriage. These are all normal reactions. In addition to monitoring this pregnancy carefully, you may find it helpful to remind yourself that the overwhelming majority of women who have a miscarriage go on to have successful pregnancies. Listen to yourself, and respect your needs and limits.
And remember, every ending carries within it the seeds of a new beginning.
A version of this article originally appeared in the Winter 2005 issue of Conceive Magazine.