Holding in your heart what your hands can not hold: The Disenfranchised Grief of Miscarriage
Becoming a mother may seem like a natural part of a woman’s life. However, miscarriages account for 12 to 32% of pregnancy-related complications*. These losses are often sudden and unexpected, and can shatter the emotional stability of even the strongest woman, leaving her feeling angry, depressed, guilt-ridden and hopeless. Sadly, even though miscarriages are not uncommon in women of reproductive age, due to the ambiguity that can surrounds this type of the loss; the grief process can be prolonged and complicated.
Miscarriages, like other losses due to death, trigger a variety of negative emotions and can alter one's life path. Unique facets of the grief associated with miscarriage include the lack of time spent with the lost loved one, and fewer memories to reflect on during the grieving process. Most of all, is the confusion surrounding the validity to mourn a life that had yet to begin, as well as the lack of prescribed rituals to publicly mourn or to receive emotional support*. Having no body to bury and no funeral at which loved ones offer condolences, grieving mothers often suffer in silence. Additionally, when family members, friends, co-workers and medical providers are insensitive, offering invalidating statements such as “perhaps you will be able to get pregnant another time” or “something must have been wrong with the baby” can further intensify feelings of guilt, isolation and rejection. The subsequent shame and secrecy surrounding the loss of an early pregnancy can leave bereaved mothers struggling to make sense of their loss and how to navigate the grieving process.
Miscarriages can also be traumatic when medical implications are considered. For example, the mother who miscarries at 6 weeks gestation, who experienced mild cramping, and received a dilatation and curettage (i.e. D&C) without complication, may experience a different grief response than the woman who miscarried at 16 weeks, who had already named the baby, heard the heartbeat and had to undergo surgery to remove fetal remains. Traumatic life factors that may have contributed to pregnancy loss, such as a vehicle accident, or injuries sustained while the mother was performing an official duty, could also increases feelings of guilt as well as trigger post traumatic reactions.
Whether the miscarriage was seen as a devastating event, or the mother was somewhat relieved by the spontaneous end to an unwanted pregnancy, the experience can create and reveal anxieties about self worth and doubts towards future abilities to conceive and give birth. Not surprisingly, if mothers who suffered a miscarriage experience disenfranchised grief, fathers receive even less acknowledgement and support. In recent years, men have become more involved with the child-rearing processes, yet little support exist surrounding men's grief reaction to miscarriage*. In essence, men are expected to care, but not too much. This disparity can caused men to internalize their feelings, or to avoid them with maladaptive behaviors (e.g. alcohol, work, anger). Both responses prevent the bereaved father from processing their grief and rendering them ineffective in supporting the mothers.
Since the emotional distress experienced among bereaved mothers and fathers can range from anger to guilt and depression, acknowledging and expressing ones grief can aid in healing. Similar to other losses due to death, bereaved parents can benefit from openly expressing themselves with empathetic support people and professionals. Whether their story includes reflecting on the specific thoughts and emotions experienced before, during and following the loss or sharing the anticipated life the grieving parents expected to have. The bereaved must acknowledge what was loss in order to heal the wound that the loss left behind.
If you or a loved one has experienced pregnancy loss or a miscarriage, please rest assured that you are not alone, and acknowledgment starts with you. When you can accept that there was a loss of life, you can in turn validate your right to grieve. Even if those around you are struggling to offer validation, self-validation can hold the key to healing. While seeking support from a professional does not replace support from loved one, having a safe place to begin the process of grief can guide you through the process.
While the grieving process is very personal and complex, there are a few helpful suggestions that could aid in healing.
Identify safe people with whom you feel comfortable sharing your story. This could be a partner, friends or family, but can also be achieved by joining a grief support group.
Consider what rituals will help you honor and acknowledge the loss, and practice the ritual. Without a body to bury, a funeral may be out of the question. But a intimate or social gathering where support and condolences can be received may be helpful.
Express your thoughts and feelings is whatever manner feels natural. Journaling, drawing, talking, crying are all ways to release emotions and honor your experience.
Resist and challenge shame-based, critical self-talk as a way to limit negative grief-related emotions. Creating self-affirming, compassionate scripts to draw from when negative self-talk creeps in. This can be done by posting encouraging words around your home, for easy access reminders.
Accept help when offered. Strength only happens when you carry something heavy, but not all burdens have to be carried alone. When navigating grief, accepting help is never a sign of weakness. If someone offers support, trust that they are offering support because they want to help. You are not being a burden.
Grief exists in the proverbial eye of the beholder. According to Carl Jung, "the shoe that fits one pinches another". Therefore, there is no perfect recipe, ritual, or response to grief that suits everyone. As outsiders, it is not our job to advise the bereaved how to grieve. For we cannot tell someone what hurts them, we can merely listen, validate and be there.
Be well my friends, and live present
Brier, N. (2008). Grief following miscarriage: A comprehensive review of the literature. Journal of Women’s Health, 17(1), 451-464
Rinehart, M.S. and Kiselica, M.S (2010). Helping men with the trauma of miscarriage. Psychotherapy Theory, Research, Practice, Training, 47(3), 288-295
Wojnar, D. , Swanson, K. & Adolfsson, A.S. (2011). Confronting the inevitable: A conceptual model of miscarriage for use in clinical practice and research. Death Studies, 35(1), 536-558