Miscarriage and pregnancy loss can happen for a number of different reasons. Like any loss, it can have a significant emotional impact on families. Grief, depression, and anxiety are common reactions after a pregnancy loss. Approximately 10% of known pregnancies end in loss.
Types of pregnancy losses
A chemical pregnancy is the earliest type of pregnancy loss you can experience. This type of loss occurs within the first few weeks of pregnancy. Some women have a positive at-home pregnancy test, only to find out that they are not pregnant when they have an ultrasound at the OBGYN. Some women may experience bleeding and cramping, but others do not have any symptoms.
A miscarriage is a loss that happens during the first 20 weeks of pregnancy. The risk of a miscarriage is highest during the first 13 weeks of pregnancy and decreases thereafter.
A stillbirth is a loss that occurs after 20 weeks of pregnancy. It is further divided into early (20 to 27 weeks), late (28 to 36 weeks), and term stillbirth (after 37 weeks).
What are the signs of a miscarriage?
The signs of a loss can vary depending upon how far along you are in your pregnancy. Common symptoms of a miscarriage include abdominal cramping, pelvic cramping, and vaginal bleeding. If you suspect that you may be having or have had a miscarriage, your doctor will conduct an ultrasound and check your human chorionic gonadotropin (hCG) hormone levels. If you think that you may be experiencing a miscarriage, seek medical attention right away.
What are the causes of a miscarriage?
The risk of a loss is most common during the first trimester and then significantly decreases after a pregnancy reaches 15 weeks. There can be many different causes of a miscarriage, but the most comon is chromonosonal abnormalities in the developing embryo or fetus. Both a sperm and egg contribute 23 chromosomes during fertilization, which pair up with one another. If something goes wrong during this process, a chromosomal abnormality may occur. Some chromosomal abnormalities can survive, like in the case of down syndrome, but others cannot continue to develop. This can lead to a pregnancy loss.
Certain maternal factors can also increase the risk of a miscarriage, including older age, thyroid problems, diabetes, smoking, excessive caffeine use, and poor nutrition. If you’re concerned about your risk for a miscarriage, speak with your OBGYN and/or reproductive endocrinoogist.
The emotional impact of a loss
Pregnancy loss can have a significant emotional impact on families. Experiencing a miscarriage can lead to grief, depression, and anxiety.
Grief and depression
Parents who experience a pregnancy loss may develop grief that can turn into depression. Grief is a common emotional response to a loss. It involves emotions like sadness, shock, and anger. Many people who develop grief after a loss initially have a hard time, but slowly start to accept the loss and return to their previous level of functioning. Other people may go on to develop depression. Signs that you or a loved one may be depressed include:
- Feeling down most days for a large portion of the day
- Feeling less interested in things that were once enjoyable
- Changes in weight or appetite
- Feeling more tired than usual
- Thoughts of suicide
Anxiety is excessive worry that interferes with many areas of a person’s life. It is a common response to a miscarriage. After a pregnancy loss, parents may become preoccupied with thoughts about what happened or what could happen in the future. For example, it’s common for the mother to blame herself and also fear future miscarriages. Anxiety can range from mild to severe and can affect your appetite, sleep, energy level, and ability to focus.
If you’re dealing with anxiety following a pregnancy loss, you may find yourself having negative thoughts that are irrational. For example, you may blame yourself for the loss despite your doctor telling you that it was not your fault. It can be difficult to let go of these thoughts, even when people tell you that they are false. Read on to learn ways to cope with the emotional impact of miscarriage.
Grieving your loss
Grief is a painful process that is unique to each person. There is no correct way to feel or deal with grief. Mental health professionals refer to the stages of grief, which include:
During denial, you may experience shock, confusion, and numbness. You may try to avoid thinking about the loss and resist accepting that it is real.
The anger stage involves frustration and rage. Your anger may be directed toward yourself or others.
During bargaining, you may find yourself thinking “what if?.” You may think about the loss over and over and wonder how it could have been prevented.
Depression happens when you acknowledge that the loss is real. As a result, you may feel sad, hopeless, and disconnected from yourself and others.
The goal following a loss is to come to a point of acceptance, where you can acknowledge that the loss has happened and changed you, but you can begin to work toward moving forward. It does not mean that you are okay with what happened, but rather that you feel a bit more at ease and can imagine living a meaningful life despite this loss.
As you deal with your grief, you may go through one, some, or all of these stages. You may even go through them in a different order than they are presented. There is no right way to grieve a loss, but there are ways that you can help yourself cope.
Coping with a pregnancy loss
When you experience a pregnancy loss, you are robbed of your opportunity to bond with your baby. It can be helpful to find some way that feels good to you to honor your baby. Different approaches work for different families. It is most important that you feel comfortable with the way you choose to honor your child.
Some possible ways you might honor your baby include:
- Make or dedicate something in memory of your child. Some women choose to wear a piece of jewelry dedicated to their baby or plant a memorial tree or flower in their garden.
- Write a letter to your child. This can be an opportunity to express your love to your baby and any other thoughts or feelings you may have.
- Donate or do work for a charity close to your heart. You may choose a charitable organization that helps families dealing with pregnancy loss, miscarriage, or stillbirth, or you may choose another charity that is meangingful to you.
- Keep your ultrasound photos in a special place. You may decide to frame them, create a memory box, or display them in some other way.
- Hold a ceremony to honor your child. Depending upon when your pregnancy loss occurs, you may be offered the opportunity to cremate or bury your baby. Each state differs in their regulations, but do not hesitate to ask your provider or hospital about your rights. Even if you cannot hold a formal ceremony, you may be able to find another way to honor your baby.
There is no right or wrong way to cope with a miscarriage or stillbirth. You may choose one, all, or none of the suggestions above. Either way, remember that your grief is valid. If you find that speaking with family and friends is not enough to cope with your loss, you may consider other sources of support.
Support groups for families affected by miscarriage and pregnancy loss are avaliable in-person and online. They can provide you with an opportunity to share your experiences with other family members experiencing similar feelings. Many families report that they feel as if they can’t openly talk about the loss as they would if they had given birth. Loved ones may also make comments that can feel insensitive, like “it was meant to be” or “you just need to move on.” Support groups provide a forum to openly express a range of feelings about what you’re going through, whether it be anger, hurt, jealousy, or shame.
- Postpartum Support International (PSI) provides a directory of local face-to-face support groups that you can narrow down by speciality. There is an option to search for grief support groups.
- You can also search Psychology Today for local therapists that offer a pregnancy loss support group.
- SHARE Pregnancy and Infant Loss Support offers an online chat for people coping with pregnancy loss and pregnancy after a loss. The organization also hosts several online bereavement support groups, including one in Spanish.
For more information on pregnancy loss, see the following organizations:
- SHARE Pregnancy and Infant Loss Support offers information, resources, and support for anyone dealing with grief and loss related to pregnancy or infancy. The site also provides information in Spanish.
- Unspoken Grief includes articles related to miscarriage and pregnancy loss. You can use the site to hear others’ stories or share one of your own.
- Still Standing Magazine features personal stories on pregnancy loss, child loss, and infertility. The site offers the opportunity to read and share.
- The Miscarriage Association is based in the UK and offers information, personal stories, and online support.
- Pregnancy After Loss Support provides online, local, and emergency support for mothers who are pregnant after experiencing a loss.