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Unexpected endings: miscarriages

30 November, 1999

For most parents, the sudden and unexpected loss of a child through miscarriage is an emotional as well as a spiritual crisis. M. Fran Rybarik describes the unique sense of loss parents experience and suggests ways in which family and friends can support them in their grief.

Most people are surprised to learn that one third of all women experience a miscarriage. Most of these occur before the fourteenth week of pregnancy, and their cause is usually unknown. Miscarriage is traumatic for most parents, and they need support from family and friends to work through their grief.

Impact on parents

Parents who had been preparing to become parents must cope with the loss. Feelings of anger, guilt, relief, or uncertainty may be very strong. Family gatherings and other social events may be difficult for the couple, especially if other family members or friends are pregnant. Even core beliefs can suddenly come into question. Everything the parents believed about life and love seems threatened. One man asked, “What kind of God is this?” Even though death is seen as part of life, babies aren’t supposed to die.

The early weeks of pregnancy are often a time of mixed feelings for both parents. From moment to moment they may rejoice about the pregnancy, wonder if this is the right time, wish the woman wasn’t pregnant, wonder who the baby will look like, feel scared, happy, depressed, and everything in between. These reactions are normal, whether it is the couple’s first or fifth pregnancy, whether it was planned for years or is a total surprise, whether the parents are younger or older. If the pregnancy suddenly ends during this time of ambivalence, the parents may wonder if their “negative” feelings affected the pregnancy. Miscarriage is often an event that will never be forgotten.

Grief is normal

If you have not had a personal or family experience with miscarriage, it may be difficult for you to understand how someone could grieve for a baby who was never seen, heard, smelled, or touched. But in today’s technological age, most couples know the woman is pregnant within days of conception. They may see a picture of their baby or hear the heartbeat long before any changes are visible in the mother’s body. Parents come to know and love their baby through these experiences, and begin to plan, hope, and dream about the future. Grief is proportionate to the attachment the person had to the one who died, not the length of the pregnancy.

Not the same status

A caring presence is one of the best gifts we can give to parents who are often numbed and in a state of shock from the unexpected loss. It’s okay to say, “I’m sorry” or “I don’t know what to say.” Some statements, though, can hurt more than they help. Being told that they now have an “angel in heaven” won’t help parents who want a baby here on earth. Avoid saying things such as “It’s God’s will,” “This happened for the best,” “Better that this happened now before you got to know the baby,” “I know just how you feel,” or “You’re young, you can have other children.”

Ask, listen and help out

When the numbness wears off, parents may find themselves searching for and yearning to know a reason for the miscarriage, especially as the due date approaches. They may obsess about the baby or about getting pregnant again. These feelings can be very unsettling. Some parents find solace in joining a pregnancy loss support group. Some find it helpful to write in a journal. Others seek out more information at the library or in bookshops. As the months pass, family and friends need to keep in touch.

Grieving is a process of remembering – not forgetting – the person who died. Acknowledge the parents with a card, note, or flowers on special days, such as the due date or the anniversary of the miscarriage. Remember that Mother’s Day, Father’s Day, and other holidays may be difficult times, especially the first year. By remembering, you will bring them comfort.

Learning to trust again

Mary’s story is an example of this. Mary and her husband, David, were in their late 20s and had a four-month-old son when they learned that she was about six weeks pregnant. Her initial reaction was one of disbelief. Another baby wasn’t planned so soon. The pregnancy was complicated by the possibility that the fertilized egg had implanted itself in the fallopian tube, where it would be unable to grow into a healthy, full-term baby. Mary and David focused on the medical crisis and spent their energies worrying about which test to try next.

Many tests later, they were told that the egg had implanted itself in the uterus and that the pregnancy was normal. They began to think about changes they would need to make to accommodate two babies just a year apart in age. At 10 weeks Mary miscarried. When she saw the tiny baby in the tissue, she wondered at the miracle of life and death within 10 short weeks. She was sure that the baby was a boy.

Mary and David went through another phase of disbelief. Tears of sadness, frustration, and relief were shed. Mary wanted to become pregnant again soon, but David felt that the miscarriage was a sign that they should wait. They readjusted their plans and began to integrate this experience into their lives.

Six months later May conceived again. This pregnancy was completely different from the other two. Mary had some cramping and bleeding. The doctor’s recommendation to “just wait and see” was difficult for David and Mary. They thought it would get better once they passed the 10-week point in this pregnancy. Looking back, Mary says she was concerned throughout the pregnancy. “Once you’ve had the rug pulled out from under you, you know it can happen again – any time.” When their son was born before the due date, they rejoiced that he was small but healthy.

One never forgets

Mary and David’s story shows that pregnancy loss is a lifelong parenting and bereavement experience. Grief is not measured by how long the pregnancy lasted. Grief does not end at a certain time, nor does it continue as an acute, intense response. With support from family and friends, parents go on with their lives, but they are never quite the same again.

Twenty years later, David and Mary were reminiscing on the good and bad times of their lives – a mid-life review. They talked about the baby Mary had miscarried. They talked about how their family and neighbours helped them through the first weeks. They wondered what their life would have been like had that baby lived. They were happy that they didn’t have three boys in their teen years at the same time, but they realised that they had always been the parents of three children. They were still grieving the loss, but the feelings were much different now. They decided to name their baby Michael, and have his name inscribed on a memorial to unborn babies.Learning to trust again is a major issue following a miscarriage. Grief won’t go away with the next pregnancy. As the parents reach different developmental stages of adulthood and experience other deaths and life transitions, they may revisit their miscarriage experience and see it in a different light.These statements may not be true. Instead, asking about the pregnancy can open the door for parents to talk about their experience – and for you to hear the meaning of this loss to them at this time. Listening and not judging is what they need most. Sometimes doing basic tasks is the biggest help – preparing a meal, caring for children, doing the washing, bringing groceries, or cleaning the kitchen.Grieving after a miscarriage can also be complicated in that it is not given the same cultural status as the death of an older child or adult. There is seldom a public display of sympathy such as an obituary, a memorial service, or a funeral. Family and friends may express concern over the mother’s traumatic experience but fail to acknowledge the death of a baby and its emotional impact on the family. One woman said it well: “Why can’t anyone ever say that my baby died?” By not acknowledging miscarriage as a death, she felt people were refusing to acknowledge that her baby had existed.Grief is a normal, healthy response to loss, and 71-75 per cent of women perceive miscarriage as the loss of a baby. However, not everyone who experiences this kind of loss grieves in the same way. Family and friends should respect the parents’ right to express whatever they feel or think – even if it seems strange. Of 100 women who had miscarried, over 40 per cent thought they were going crazy, and had the desire to do things that seemed odd or irrational. Expressing feelings, whatever they are, aids in the healing process.When a pregnancy ends in miscarriage, parents are forced to make many adjustments. In early pregnancy, the mother’s body produces hormones in amounts different from normal to maintain the pregnancy. Suddenly, the woman experiences pain and bleeding, possibly even surgery, and her body must once again readjust its hormone levels.

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