Experiencing loss after pregnancy

A co-worker and her husband tried for a decade to have children. Her first two pregnancies ended in miscarriages in the fourth month. Then they were blessed with a healthy baby girl. But upon trying to provide her with a sibling, the couple ran into the same problems as before, but this time in the more extreme; the co-worker’s body would “fight” with the baby it was carrying, usually around month seven or eight. The fetus would be a casualty and the co-worker barely made it those last two times. Those of us around her marveled at her stamina but worried about the toll on her emotion, mental and physical health and on their marriage. While her situation was tragic, it is far from uncommon.  

The American College of Obstetricians and Gynecologists say that “fifteen to twenty-five percent of all clinically recognized pregnancies will end in a miscarriage.” A miscarriage is officially defined as a pregnancy loss that occurs before 20 weeks gestation, according to the March of Dimes. (A miscarriage after 20 weeks, when a fetus could be viable outside of the womb, is called a stillbirth.) Miscarriages are emotional and physical rollercoaster rides for women and their partners. And part of this is not only due to the circumstances and the loss, but to the negative stigma attached to the labels used for miscarriage such as “spontaneous abortion”. 

And while the fetus may be aborted or expelled unexpectedly from the body, miscarriages are usually a process and not a single event. Fifty to seventy-five percent of those miscarriages will be a chemical pregnancy, meaning that “a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of a woman’s expected period,” says the American Pregnancy Association.  A chemical pregnancy is oftentimes liked to a chromosomal abnormality in the fetus, and a woman may not even realize she’s pregnant at that time until she experiences stronger than usual cramps, or what may feel like contractions, mild to severe back pain, and then a clot that may contain tissue passing from the vagina, followed by a heavier than usual menstrual period. 

Risk Factors for Miscarriage:

Miscarriages can be caused by numerous things, not limited to:

• Hormone problems, infections, maternal health problems (such as fibroids, scar tissue from past surgeries, insufficient progesterone, uterine defects)
• Lifestyle issues (excessive caffeine, tobacco, drug or alcohol use/abuse, malnutrition, exposure to radiation or toxic substances)
• Improper implantation of egg in the uterine lining
• Maternal age
• Maternal trauma

The above causes may result in chromosomal abnormality in the fetus or a blighted ovum.   

Recovery from a miscarriage or a stillbirth:

Regardless of the cause of the miscarriage, the March of Dimes says, “It takes weeks to a month or more for a woman to recover physically, depending on how long she was pregnant.” But the emotional affects of the miscarriage may last much longer. 

“Women and their partners may experience intense grief as they mourn their loss. A woman may experience many emotions, including numbness, sadness, guilt, depression and anger, as well as difficulty concentrating,” according to www.marchofdimes.org. 

The work of Swiss psychologist Elisabeth Kübler-Ross, summarized in her book On Death and Dying, can apply to miscarriages also, as even if the fetus wasn’t far along or even if the woman didn’t understand she was pregnant until the time of miscarriage, the miscarriage is still a death or a loss. The expectant parents might go through denial, anger, bargaining, depression and acceptances—the five stages of grief—for the baby they may never had gotten the chance to meet. 

To work through the stages of grief, the Elisabeth Kübler-Ross Foundation (www.ekrfoundation.org) suggests the following ways to cope:

• Join a support group for parents who have been through the same thing. (dailystrength.org has online support groups; Beryle Greenwald runs a group for Pittsburgh parents who have been through a still birth; see missfoundation.org for more information)
• Therapy with a qualified mental health professional. 
• Journaling to help work through the myriad of emotions.
• Eating well. We can’t work through grief if we aren’t at our strongest physically.
• Exercise. Endorphins released during exercise help combat the emotional and mental anguish during the grieving process.
• Rest. Body, minds and spirits all need to rest to recharge. 
• Reading and learning about death-related grief responses, to better understand your feelings.
• Seek solace in a faith-based community or with others who share your beliefs.
• Seek comfort in rituals, such as memorials, planting a tree or garden or donating to a cause.
• Allow your emotions to flow. Bottle emotions can cause anxiety. It is better to just let lose what you are feeling so you can properly grieve and heal. 
• Avoid major changes such as household moves, divorce or separation, or any other life changes while you undergo the stages of grief. 

Most importantly, remember you are not alone. Based on the statistics, somewhere, probably nearby, someone else is going through the exact same things you are.