By Sharon Covington, MSW, LCSW-C

	Introduction
	Why Does This Hurt So Much?
	What Can Help?
	Internet Resources

Introduction

It is often difficult for people to understand what a profound loss a miscarriage can be for a couple. After all, “it was only tissue” or “you didn’t really know it” or “you can have another”. But when you have experienced the elation of learning you are pregnant, only to feel the despair of discovering you have miscarried, the magnitude of the loss is understood. It is a shattered dream – the death of a wished-for child.

Grief is the feelings you have about the loss of your baby. Grieving is the normal process you go through in trying to come to terms with this loss. The feelings occur in a somewhat unpredictable and repetitive sequence. Initially, there is a phase of SHOCK AND DISORGANIZATION. There is a feeling of numbness, disbelief and a sense that this can’t be happening to you. This feeling can last for a few hours or a few weeks.

Then a period of VOLITILE EMOTIONS can occur as you try to understand why this happened. You may experience intense feelings of anger, sadness and guilt. Anger may be directed towards those closest to you (spouse, family and friends) or those seen as having power and control over you (doctor and God). When anger is directed inwards it becomes depression. Guilt can be overwhelming for in trying to find answers, you often blame yourself.

As intense emotions start to subside, a phase of LONELINESS AND DEPRESSION occurs. The reality of the loss sets in along with feelings of sadness, fatigue and powerlessness. These feelings may peak between three to nine months following your baby’s death.

Finally REORGANIZATION occurs and you begin to experience renewed pleasure in life. Your baby’s loss has become accepted – not in the sense of being right or fair but only that it happened. It is no longer consuming all your energy and emotion.

Now only SHADOW GRIEF remains. Feelings of sadness can be rekindled around significant days or events, such as your due date, conception date, and anniversary of your baby’s death. Special holidays, events, places and changes of seasons may also trigger memories of your baby. Shadow grief is a reminder that your baby will always hold a special place in your heart.

“Why Does This Hurt So Much?”

The loss of a baby early in pregnancy can be difficult to mourn. There may be no tangible evidence of your baby’s existence, which adds to a sense of unreality. You find yourself grieving over the hopes, dreams, and fantasies you had for your child rather than real memories. Also, other people may not have known you were pregnant and thus are not aware of your loss. In addition, when a baby dies during pregnancy, traditional mourning rites and rituals are not encouraged, as the baby is known only to you. There are no viewings, funerals, or religious services. You may be encouraged to repress your feelings and to forget your baby. Thus, you can find yourself suffering intense emotions in virtual isolation.

Other factors can complicate the grieving process after a miscarriage. If you experience difficulty in conceiving, you have greater emotional investment in a pregnancy. Hence, the loss of this precious baby has greater emotional significance. And yet this loss can bring hope as you were able to conceive. If you had an ectopic pregnancy, you may have been faced with a life-threatening situation which overshadows emotional issues. After physically recovering, you can find yourself grieving a dual loss – your baby and potential fertility. Finally, your baby’s death can rekindle many hurts from the past, such as other losses, deaths, family or job problems.

“What Can Help?”

Mourning the loss of your baby can be hard work that takes time and drains energy. Be aware that your reactions are normal, with many ups and downs. Grieving takes far longer than society recognizes. Grant yourself the freedom to allow this complex process to occur. Here are some ways to help you cope:

1. Recognize that a miscarriage is a significant and real loss. For most couples, it is not the shedding of tissue but the death of a baby. To acknowledge this loss, you may want to name your baby; give a donation or gift to a special charity; have a memorial/religious service; or plant a tree in your baby’s memory. Even if no one else is aware of these gestures, it can help you feel better.

2. Understand that husbands and wives will feel and deal differently with this loss. A father may not have been as bonded with the baby as the mother and thus may not experience as great a loss. The way you express your grief is very personal and may be different than the way your partner deals with feelings. This can be a time of special closeness or increased conflict. When you are both hurting, you may not be able to give and receive support as you have at other times. Be patient with each other and keep communication open.

3. Prepare ahead for reminder days. Your due date, holidays, and the anniversary of your miscarriage can be difficult times. You may be anticipating them with sadness and dread, while family and friends seem to have forgotten. It will be important to let others know how you are feeling so that when the day arrives, you are not double disappointed. Finding a meaningful way to commemorate your baby at these times can help such as planning a special dinner; lighting a candle; attending a religious service; or making a memorial donation.

4. Find a support system. Clinical research has shown that a couple’s ability to satisfactorily resolve their grief is in direct proportion to their finding suitable ways to express their feelings. Talking to a friend or relative who has had a pregnancy loss can help. Support groups for couples who have lost a baby in pregnancy or after birth provide a valuable means of understanding, sharing, and resolving feelings. Although individual experiences may be different, the common bond these parents share are their feelings.

MIS (Miscarriage, Infant Death, and Stillbirth) is a self-help support group meeting in various locations around metropolitan Washington, D.C. Services are free and include monthly support meetings for the newly bereaved and for those pregnant following a loss; telephone counseling, information, and referral; a lending library; and community education programs. Call 301-460-6222 for a recorded message on contact people and locations.

Internet Resources:

• RESOLVE – The National Infertility Association
• InterNational Council on Infertility Information Dissemination (INCIID)