Miscarriage or Perinatal Loss

If you are reading this, you or someone you love may have miscarried a baby. It is an experience that many will never need to go through, but also an occurrence that many others will encounter unexpectedly.  It is tragic, harsh, and totally and completely unfair; yet thousands of families will find themselves in this position every year.

The truth is that most miscarriages are outside of one’s control. In the United States, 15-20% of confirmed pregnancies end in miscarriage and 1 in as many as 160-200 pregnancies are stillborn. Even knowing these statistics, it is common to feel empty and question, “Why me?” “Why us?” Bereaved parents may feel great sadness, regret, shock, confusion, some or all of these emotions.

There may be anger directed toward the doctor, a spouse, or other women who have been able to conceive easily and carry their pregnancies to full term. Many women blame themselves for a miscarriage. There may be feelings of guilt, as if there were something that could have been done to prevent this loss. For some bereaved, they may experience the sense that no one can understand the depth of this loss. It may appear that some of the people closest to you simply do not grasp what is being experienced. Others may want to empathize, yet are unsure how to relate, especially if they have not experienced a miscarriage themselves. They may not comprehend just how real your baby was to you, despite never holding it or if so, only for a brief while.

Loss from a miscarriage is challenging because you grieve for a person you never knew, and for a relationship that ended before it really began. You grieve not for a person who has lived and died, but for the hopes and dreams that you held for your baby and your family. You grieve for the loss of your future as the parent of this baby. You are heartbroken not just because of what you have lost, but because of what will never be.

Another way in which grief after the loss of a baby is different from other kinds of grief is related to the possibility of another pregnancy in the future. Feelings about what has happened may be mixed with anxieties about why it happened, whether and when pregnancy might occur again, and if it does, fear as to whether the next baby might die as well.

It may be difficult to be around families with healthy infants for a while. Even after you believe you have moved on, grief can return without warning. The baby’s due date or Mother's Day can bring back emotions of sorrow and longing. Some women have a resurgence of grief when they become pregnant again.

Another consideration is that the body, during pregnancy, and especially after a miscarriage, has a significant shift in hormones that can affect your emotions and coping.  Postpartum depression, anxiety, and other mood disorders can affect a mother regardless of the point at which the baby is delivered.  When someone is grieving after they have had a significant shift in body chemistry, it can be especially challenging.

It is important for those who have lost their children to know that they are not alone, to believe that there are many others who need to navigate this loss, too.

How long and how deeply one grieves depends upon many different factors. Such as when the miscarriage occurs. If it is later in the pregnancy  there was more time to prepare for the baby such as choosing a name, or the nursery was already decorated.

Support plays an enormous part in the grief process. If possible, consider attending a specific support group for parents who have lost a child such as UNITE or Compassionate Friends. The group, Share: Pregnancy and Infant Loss Support lists support groups in many states. There are also online supports such as throughtheheart.org or The Miscarriage AssociationUK.

Support each other. Your spouse or partner is grieving as well, even if it is hard to recognize. You may both be feeling the same, or very different emotions. You may need to talk, while he can’t find words for his feelings. If you are not connecting, seek the help of a counselor who can help you understand and support each other.

What do we tell the children?

When adults experience a traumatic event like a miscarriage, they often are so consumed by their own grief that they fail to see that their children may be struggling with the same emotions. They may ask what they should tell the children, if anything. Some parents may feel that the children are too young to be told about the miscarriage or believe they would not understand. If the surviving children were not aware of the pregnancy, there may not feel like a need for them to know about the loss. Although you may not have told them about the pregnancy or the loss, they will likely know something is wrong and may act out. You might have been tearful, in pain or angry, or you might have been in a hospital and away from home. The children’s routine might have changed, people could be speaking in hushed tones, and other family members may be visiting or bringing meals. It is often difficult to hide changes such as these from children. Often a child feels or sees this change and worries about the parents’ sadness and grief, yet may not have the skills to talk about it. If children are not told what has occurred, they often develop their own ideas of what has happened, such as mom is sick and dying or I must have done something to make everyone act differently.

It is usually best to be honest, to use simple language and to give clear explanations. If you say, “lost” to young children, they may think you mean “misplaced” and may worry that they will get “lost” as well. If you say the baby has fallen asleep, they may become frightened of falling asleep or have nightmares. You may also need to reassure them that the miscarriage was not anyone’s fault. They might believe that they are somehow to blame, especially if they weren’t happy about the idea of a new sibling. One of the children who came to my bereavement camp carried the guilt of his baby sister’s death for nearly five years. He believed that because he asked God for a baby brother and not a sister, he had somehow caused her death. It was only by talking about it and processing those feelings in a supportive, safe environment that he came to understand that he had done nothing wrong.

If your children were aware of the pregnancy, they would probably need to be told about the miscarriage promptly. If they are small children, a later time might be more appropriate when they are more able to comprehend what has occurred. Very young children are likely to pick up on the feelings of the adults around them, but will not fully understand the finality of the loss. Children under five will have some awareness of death. They may ask questions to try to make sense of what has happened, such as “Where has the baby gone? When will the baby come back?” By the age of eight or nine, most children will have a reasonably full understanding that the baby is gone and not returning. “We explained to her that sometimes for no reason and through nobody’s fault, babies can die. We said it’s like planting seeds – only some of them grow into healthy plants. I told her that sometime these things happen for no reason at all, that it was just not meant to be. I also told her that I was extremely lucky to have her.” Teenagers will think about death like an adult. At any stage, there will most likely be questions about the baby that died as the loss is processed.

Children as well as adults react in their own way to a miscarriage. You may see the child being more “clingy”, acting out at home or school, or having tantrums. They may have disturbed sleep, appetite or concentration. They may have a lot of questions and need to share them with you or someone else they trust. They may also withdraw. When parents can share their grief with their children openly and honestly, it can be extremely helpful because it implies to the child that it is understandable to be sad. This is a loss and as a family, will move through it together. Some suggestions to help acknowledge the death are: