Pregnancy loss refers to the unexpected loss of an unborn baby. Miscarriages are the most common category of pregnancy loss. A miscarriage is defined as a pregnancy loss that occurs before the 20th week in pregnancy. Most miscarriages usually happen before the end of the first trimester. The other categories of pregnancy loss include stillbirth, birth loss and medically based termination.
Pregnancy loss is devastating. Women speak of it being one of the worst experiences in their life. Women’s descriptions of distress include: crushing disappointment, anger, sadness, depression, anxiety, panic, guilt, shame, confusion, helplessness and somatic difficulties. Men process their distress differently than women. Whereas women cope by talking about their pain and seeking support from their husbands, men tend to keep their painful feelings more private and cope by keeping busy as they try to make sense of their loss. Men sometimes have delayed or displaced responses. This means their pain may become evident by coping difficulties noted at work or in previously good relationships.
A woman’s pain is exacerbated by the perception that her grief is not understood by others. She has felt the presence of her baby and been in relationship with him/her. The loss of the pregnancy is actually multiple losses. These include the loss of the baby, the loss of the hopes and dreams invested in this baby while the pregnancy was viable, the loss of this opportunity to become a parent to this particular child.
Grieving a pregnancy loss is a crucial part of the process through which both spouses (wife and husband) not only survive the deep emotional impact but also reclaim psychological wellbeing and a sense of being in control of their life. Guidelines for grieving include:
- Take good care of yourself. This includes being gentle with yourself, relaxing, getting adequate rest, nourishing food, moderate exercise.
- Nurture the relationship with your spouse. Talk with each other and remember that men and women grieve differently. Be sensitive to each other’s needs and feelings, accept differences as you acknowledge each other’s pain
- Seek out support from family and friends. Do not expect anyone to intuitively know what you need, want, think or feel. It is important for your healing to speak your needs clearly and directly.
- Journal your thoughts and feelings.
- Develop a grief ritual or rituals that mark the importance of this loss. This ritual should enable you to express your feelings about the pregnancy and the loss of your baby. An example of a ritual is writing a letter to the baby that shares your thoughts and feelings and allows for a good bye.
In our culture, there are no clear and acceptable ways to respond to a pregnancy loss. Family members and friends who want to be supportive and offer comfort often do not know what to say or how to be present in a caring way. Couples who have lost their baby tell us that the following guidelines are helpful.
- acknowledge the loss and do not ask for details.
- be an empathic listener who honors the couple’s needs to talk in their own time.
- be responsive to needs and requests even if you do not understand their relevance.
- do not give advice unless it is specifically requested.
Psychotherapists who have a specialty in pregnancy loss can help by providing a safe space and expertise for working through and healing this painful and profound experience.