Miscarriage and Grief

As women, we regard our foetus’ as part of ourselves. Miscarriage is a complex grief that leaves us particularly vulnerable. Grief Issues Special to Miscarriage involve 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.

Grief issues special to miscarriage are unique (unless someone has disappeared) in that we have very little remains to bury. This is either 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 instead of being shown respect if not empathy for our feelings. This can lead us to question our feelings of grief leaving us sad and vulnerable. 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.

Compound grief

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 and the physically invasive conception process stretches women’s coping skills. The associated psychological issues and the uncertainty of a successful pregnancy can result in anxiety and depression. This may  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. http://www.scoop.co.nz/stories/SC1309/S00056/otago-researchers-make-brain-fertility-break-through.htm

Talking about miscarriage

A funeral normally gives people their cue of how to behave appropriately with protocols to follow. 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 feel we need to explain this. 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’.)

All information helps to normalize our feelings which can change at different stages and also show different aspects when a later miscarriage is involved. Because miscarriage is such an ambiguous loss, the other losses along with it are more difficult to explain. Talking to someone who has had a miscarriage can offer the most comfort and empathy. This can be a grandmother, mother, sister, friend or medical professional. Unexpected comfort can come from a woman who is an acquaintance or even a stranger (as on a Facebook page) 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. Also possibly future ones and the festivities around that
• the thought that our body failed both of us – my body – I failed
• 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)
• dealing with others’ inappropriate comments, some with the best of intentions
• no answer to why, means blaming ourselves
• 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 loss of the achievement of a goal we had set for ourselves (this may not have been experienced before)
• 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 our basic trust in life and the fear and insecurity of a less predictable world
• the threat of loss of our identity
• the loss of self-confidence
• the loss of control of our feelings
• dealing with the thoughtless attitude of others, who have children without experiencing problems. They can be complacent, smug or pitying (perhaps unintentionally)
• 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’. 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 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 loss of the belief system we didn’t even necessarily recognise we held that says “this won’t happen to me”
• the thought that we have somehow killed our baby, or we did something wrong
• the loss of control over our expectations of life
• 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
• feeling inadequate
• 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
• that miscarriage grief can be prolonged and remain more poignant from childlessness
• continuing to grieve for  – the lost possibilities – the unknown – even a glimpse of the mystery of our potential little human being
• Depression
• Post Traumatic Stress Disorder – research shows almost half of women who suffer miscarriage or ectopic pregnancy show signs of PTSD

Living with no answers

Living in a world where science has overcome many things, especially in the health area. 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’ seems harsh and judge-mental. And the use of the medical term ‘abortion’ in conjunction with a ‘miscarriage’ can be deeply upsetting. A miscarriage can be seen as a minor medical occurrence by health professionals 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!’ there is also not the sense of acceptance and resignation of life’s realities as in other times.