Miscarriages and Grief

Over the last few years, our team has had the honour to work with and witness the grief of several women who have experienced a miscarriage or stillbirth. The anguish of these women has been palpable and complicated. Yet, while losing a child is almost unimaginable, parents or caregivers who lose children are often given tremendous support from family, friends, and community members; there is often a very different experience when people experience a perinatal loss. Unfortunately, the experience of perinatal loss is often shrouded in secrecy and lack of social support.

Miscarriages are Common but Stigmatised

Sadly, perinatal losses are frequent, and estimates from the United States indicate that anywhere between 10-20% of known pregnancies end in miscarriages which are pregnancies up to 20 weeks of gestation. Another 1% of pregnancies end in stillbirths.

Perinatal loss is highly taboo, and many clients I have worked with speak about the aloneness that has accompanied their perinatal loss or stillbirth experience. Regrettably, it is all too frequent that many females who have experienced a perinatal loss regularly blame themselves and even experience shame.

Blame is easy to appropriate and internalise when so much societal responsibility is placed on women to produce healthy children. So many of my clients have wondered what is wrong with them and what they have done wrong. One client told me that if she had only eaten well, managed her stress, and slowed down, she might not have lost the baby. Sadly, this self-blame prevents many women from discussing their experiences and soliciting support

While if someone loses a child, there is usually a tremendous outpouring of sympathy and support. However, because many miscarriages happen early in a pregnancy, many women typically have not informed their family members, friends, or colleagues that they are pregnant. Consequently, they might not feel like they could now turn and tell these people about their loss or their need for support. I remember one client sharing that she was now in a conundrum because, other than her partner, she had not even told her best friend that she was pregnant and had experienced a miscarriage.

Miscarriages Can Rob Women of Opportunities to Grieve

Rituals usually surround, mark, and commemorate loss and grief and would be expected if someone usually lost a child. These rituals include funerals, wakes, and get-togethers related to a loss. Ceremonies like funerals and wakes are profoundly social and provide a formal way to mark the passing of someone and the provision of support to grieving relatives and friends. However, after a miscarriage, there is usually nothing provided by medical authorities to intern, so these rituals are denied to women who have experienced a miscarriage. Having no traditions and the accompanying social support exacerbates the aloneness of perinatal death.

My work with women and sometimes their partners and family members around miscarriages and stillbirths have been about providing education, lifting the shroud of secrecy, and helping women solicit support. As I mentioned, many women often blame themselves for miscarriages and stillbirths. Yet, the reality is that, for example, most miscarriages occur because the fetus is not viable, not because of anything the woman has done to compromise the fetus’ development. Many women I have worked with find it extremely comforting to review the statistics and the basic science about stillbirths and miscarriages. Upon realising that so many women experience miscarriages and stillbirths, my clients often realise they are not so abnormal. According to one woman I worked with, the power of knowing that “It could happen to anybody” means that she is no longer deficient.

Human Connection is Key to Healing

As humans, we are social beings, so there is nothing as isolating as having to grieve in secret. The secrecy about a miscarriage, in particular, robs women of the social support that usually comes after a loss. When they share with family members, friends and partners, women might even experience insensitive remarks. More than one client had cried when they confided that the persons they talked to minimised their experience; as one client described it, her best friend told her at least she could get pregnant and she should try again.

My conversations with my clients have often involved discussing who they might want to inform about their loss and even practising how they will share this information. We also often talk about who they might not like to inform because that person might not be very forthcoming with support, be insensitive, or disparaging.

Finally, as a couple and family therapist, I have occasionally asked my clients who they might want to invite to visit with us in session so they can share and process their experiences. These collective conversations have been compelling and made many of my clients realise the power of having someone else witness their pain.

Because persons who experience perinatal loss will not have a collection of memories about the deceased, processing usually involves encouraging my clients to talk about the dreams and visions of a future they had for their child. Since there is no history, sometimes even having a memento to memorialise the loss can be challenging to find. In that case, clients have created items and bought things like jewellery and charms to commemorate their loss. I remember one of my clients purchased a bracelet; when the feelings of loss were particularly intense, she would twirl the bracelet on her wrist, honouring and remembering the infant she had lost.

Ten to twenty percent of pregnancies will end in miscarriage, and 1% of births are stillbirths, so many women are affected by perinatal losses. In addition, the grieving process can be challenging because of the weight of secrecy and difficulty soliciting support. Some strategies to help cope and encourage healing include normalising perinatal loss, finding grieving rituals, and finding people with whom to confide.

To learn more about healing after a miscarriage and healing from other forms of loss, please subscribe to our monthly newsletter.

Jomo Phillips, Couple & Family Therapist