Grief Feelings in General

Grief is the normal, healthy, appropriate but unfortunately painful response to our miscarriage loss. In time, grief feelings should eventually transmute into an accepting and bearable state for us all, albeit sometimes with help. Individual recovery time-frames depend on the each person’s support, circumstances, temperament and previous bereavements. For some it may be weeks but for others it can take months and occasionally years before they feel more like themselves. If the latter happens or if the grief is unbearably intense, some form of counselling would be advised. (It would be helpful to choose a miscarriage counsellor or a counsellor who is familiar with information on this website). Our group finds 6 months of gradually feeling better is a good average guideline. The grief process cannot be escaped without a cost.

A taboo subject

Although over 70% of women perceive that a baby is lost when a miscarriage happens, society in general does not necessarily believe that. Miscarriage is often regarded as an insignificant event, so is seldom acknowledged or discussed and often treated as a taboo subject. We have noticed midwives’ websites in New Zealand seldom have a heading for ‘Miscarriage’ amongst their others. The inference can be that pregnancies only end in healthy, full term babies. This only adds to the shock and misery when things do go wrong – whatever they may be. 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.

The unacknowledged

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 and a foetus becomes a baby. Widely held fundamental beliefs vary.

Unfortunately the key to recognising a little life lost is dependent on an acceptable community definition. A stillbirth in NZ means that the baby is born after 20 weeks gestation. This 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 discernible body. There are a no legal requirements for miscarriage like a birth or death certificate, and no obituary notice, no memorial service, or funeral formalities. Often there is little left to bury, especially if the miscarriage was early in the pregnancy or passed in the toilet. This all tends to signify that a baby never existed, even though a miscarriage is often life-changing. Bereft and shattered are two words that easily come to mind.

Chromosomal abnormalities

Even though up to 70% of miscarriages are due to chromosomal abnormalities and are no-one’s fault, this is not generally known. With no apparent meaningful explanations about the cause of a miscarriage, conscious or subconscious thoughts can result in a cultural ambivalence. It can create the 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, we can buy into this attitude ourselves, adding to our already guilty feelings and re-enforcing them and makes it easy for others to continue with that point of view.

Blame

Meaningful and descriptive words such as a ‘premature stillbirth’ or ‘early stillbirth’ would be more useful than the word ‘miscarriage’. Miscarriage 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 (Why Miscarriages Happen)

Delayed grief

It is not always accepted 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, grief may not cut in for several weeks. A late miscarriage can intensify their grief as they have had longer to attach themselves more closely to their baby. Feelings of safety and confidence increase once past the 12 week date. The baby will be bigger and may have begun to ‘show’ so people can guess at a pregnancy even if they haven’t been told.

Usually the baby’s tiny, fast beating heart has been seen and heard at a scan and the mother may even have felt the new life moving, confirming that everything is going smoothly. Statistics are also on their side – so their loss is even more poignant. But they may also find more understanding and empathy from everyone which can be helpful toward a healthy recovery. Ultimately however, comparing grief related timeframes is not useful as everyone experiences their own unique depth of grief.

Disenfranchised grief

When grieving is not acknowledged or validated by the community and not legitimised by medical professionals, the subsequent feelings can remain unresolved. 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. But each child is different and loved for their own sake. The grief is for this lost baby and the difference it would have made in everyone’s lives. It can be so stressful that many women in fact wonder if they are going mad.

It doesn’t help when women come across medical professionals, whose focus is only on the physical aspects of miscarriage. Dismissing it as a minor mishap, without acknowledging the possible emotional repercussions to their patients can be very upsetting. That attitude is disconcerting. The medical terminology used around women’s physical experience, alienates women further from what is — their body’s natural response to a baby that was never going to survive. It can feel bewildering for women to hear their baby referred to as ‘product’ or ‘tissue’ and especially referring to their miscarriage as an ‘abortion’.

Abortion

To women who have miscarried there is a huge difference between them and women who choose not to carry their baby to term for whatever reason. A miscarriage is definitely not a choice. The use of these medical words seems insensitive and lacking in compassion. Because miscarriage is not usually life threatening, the woman’s whole experience can be minimised. The medicalisation of miscarriage can oversimplify the complexity of the resulting grief. There is a general lack of acceptance and understanding of what women perceive as their lost baby. It adds to and intensifies the stress levels, mourning and isolation of miscarriage grief they then have to deal with.

Unfortunately, people can simply not know that by acknowledging what the parents are feeling, they can help their healing. Even saying as little as ‘I am sorry for your loss’ and perhaps offering a hug if it is appropriate is comforting. (See ‘Seven Helpful things to say and do’ etc.) If medical professionals openly sanctioned that the most common reason for miscarriage was from genetic abnormalities, women would feel more supported and not at fault. Genetic abnormalities is a term most would understand.

Acceptance

With acceptance of the normalcy and numbers of miscarriages, people could more easily understand what was happening. It might encourage parents to talk about their experience as they would with any loss. This would make a huge difference to help parents accept their grief without feeling that their miscarriage was being minimised and invalidated. There is seldom a burial plot and headstone for such fragile remains. However, any inappropriate comment — especially from a medical professional — can be engraved on the parents’ minds forever from the rawness of their grief and quoted even 50 years later.

Understanding

Thank you to those of you who do their best to understand. It is difficult, but know that your effort will be appreciated and make a difference at this significant time in people’s lives. You will always be remembered. However it is the general public and people close to the mother-to-have-been, who decide by default whether miscarriage grief is appropriate, how long it should last and when it may be socially shown. Given the statistics of 1 in 4 women miscarrying that is a lot of people in the community being adversely affected when the prevailing attitude is as above.

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. You may 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; Everyone is unique and express their grief differently. 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. 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.

Grief is necessary

Grief is not self-indulgence. It is a necessary, normal and healthy process to experience. Suppressed grief is unhealthy. Your feelings at any time may fluctuate and include one or more of the following: shock, loss of concentration, confusion, denial, anger, guilt, jealousy, shame, numbness, a sense of betrayal, forgetfulness, loneliness, lostness, isolation, emptiness, depression, frustration, irrational behavior, unreality and sometimes bargaining (such as trying to do charitable acts or relationship reconciliations).

There is no real sequence except for a final acceptance, and even that is qualified by having dates and other personal memories come up to remind us. However, they will gradually diminish in intensity. Some people feel this was a punishment from God, but this was an act of nature. We all tend to want to blame some-one, especially when we don’t have answers. Staying in the present can be elusive, nothing but your grief seeming particularly important, the only thing having any meaning being your baby’s death.

Time can slip by unnoticed or drag. Dates and things associated with your loss like certain tunes or scents or scenes seem to be set in your memory forever. Especially things said to you around this time. You may feel sadness in your body physically as well. Being unable to sleep even though exhausted, feeling tense or achy, cold and unexplainably shaky along with general misery can all be scary and disorienting. It may also seem strange to still feel alone and lonely even when you are well supported, however it is not unusual. It is all part of normal grief and will pass. (Some women may not feel any of this at all or at least a milder version and it also could happen weeks after the actual miscarriage.)

Guilt and Shame

Guilt is a common part of any grief, but in miscarriage it usually plays a much greater role as often does shame (thankfully, in time, they both eventually pass). 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, caused the death of your baby. It did 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.) Unhealed miscarriage grief can also eventually lead you to allowing it to define you, perhaps leading to missing out on other things in life.

Avoidance

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. (See University of Michigan Health System research April 2010 ‘Couples are more likely to break up after the loss of a pregnancy and unmarried couples are at even higher risk’.) 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 other counsellors and organizations have too) that baby loss is at least part of post-natal depression after a subsequent pregnancy.

Denial

We may be surrounded by people who live in a culture of ‘grief denial’ but it is normal to grieve following a loss. 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. It is part of the healing process and makes the pain more bearable. Consider joining an online group or a local group, or connect with friends who have experienced miscarriage. Groups can bring 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. They may have changed with perhaps a deeper appreciation for life.

Counselling

You may wish to consider counselling if it is taking longer, or if at any stage you experience particular difficulties. e.g. If you feel obsessed by your loss, especially if you have had recurrent miscarriages or other losses to compound your grief. If your feelings seem beyond anything we have covered, PTSD (Post Traumatic Stress Disorder) is also a possibility. To clear your mind from that worry, identify your symptoms by trying; http://helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm Consult your doctor for further advice.
http://www.miscarriagesupport.org.nz/miscarriage-counselling/

Grief can make some women feel driven with an excess of energy; and they offer to do charitable acts or become involved in situations to help them regain their sense of self-worth. This sometimes drains them and it can be a way of avoiding their pain. This has been referred to as the ‘missionary zeal of the newly bereaved’ which those who have experienced it will recognize.

Typical ways of coping with grief, like funerals or memorial services may not be available or seem appropriate. You may be lucky enough to have supportive friends or family to talk to but society in general doesn’t talk much about these losses. Miscarriage can be completely overwhelming. You may be hard pressed to come up with any coping mechanism at all no less productive ones. But faulty coping mechanisms don’t help us in the long run and can impede our healing. See recommended miscarriage counsellor Megan Downer.

Research

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. 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.’

When we are functioning on a reasonable level again, we think we have dealt with our grief feelings as they no longer disrupt our lives. We allow ourselves to tentatively feel joy again. Understand that grief feelings 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.

Healing

Although grief healing means refocusing and finding acceptable ways to live with your loss, it does not mean forgetting or making your memories insignificant. Nor does it mean you will like it but a healthy recovery from grief makes it necessary. The baby bond formed can last forever. Sorrow does dissipate over time and the memory becomes a part of your life. The intensity diminishes 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 for a new normality.

A poem often quoted;

An angel in the Book of Life wrote down my baby’s birth,
then quietly closed it whispering, ’Too beautiful for earth.’