Miscarriage and Stillbirth

Long before they're adults, many people imagine what it would be like to have a family of their own. They dream of happy pregnancies and healthy babies. Few people think about losing a child—but the truth is that pregnancy loss is fairly common.

When a pregnancy ends in tragedy—at 9 weeks or 9 months—grief always follows. Normal responses include shock, guilt, emptiness, sadness, anger, despair, and questioning of faith. Unlike clinical depression, most symptoms of bereavement gradually improve, although feelings of worthlessness can persist with repeated losses.

If you lost your baby later in your pregnancy, your health care providers may have encouraged you to deal actively with your grief. If your loss occurred early, people may not have been as supportive. If you hadn't yet told anyone you were expecting, your loss may seem stranger still. Whatever your stage of pregnancy, it is important to acknowledge that you've suffered a major loss and that you're mourning all the hopes and dreams you had for your child, as well as the presence of your child.

Each pregnancy loss is significant and unique.

Your grief will be affected by when and how your baby died, your age, any previous pregnancy losses, how many other children you have, and how much you wanted this baby. While stillbirth may be more physically and emotionally complicated than earlier miscarriage, this isn't always the case. Don't compare your loss or grief to that of others.

While it's impossible to predict exactly how your loss will affect you, there are normal stages of grieving you can expect. Generally, you'll move from shock through sadness and anger and into acceptance. But stages may overlap or reoccur. Just as you feel you may be done with one stage—or with grieving entirely—another wave of emotion may encompass you. If it's been a year or more since your child died and you're still having symptoms of severe anxiety or depression, talk to your health care provider.

Women and men often grieve differently, and it can compound your stress if you and your partner are mourning in different ways. Often, women want men to be more expressive, and men feel helpless because they can't ease their partner's pain.

Women may typically

• Grieve more openly and actively than men
• Grieve longer than men
• Want partners to actively grieve because it acknowledges the importance of the loss and respect for their feelings
• Feel that being listened to helps their pain

Grieving men

• May be more private about their feelings
• May be more silent and withdrawn
• May not cry or get upset because they feel they have to be strong
• Are unlikely to feel that just listening can help

Respect each other's way of grieving, and don't let it keep you from supporting one another.

Multiple pregnancy loss (three or more losses) may bring more prolonged, intense, and complicated grief. With each loss, feelings of vulnerability and uncertainty intensify, and pregnancy itself may provoke tremendous anxiety. There may be intensified feelings of inadequacy and failure or symptoms of clinical depression and anxiety. If this sounds like your experience, seek medical attention.

After a pregnancy loss, the best thing you can do is take care of yourself physically and emotionally. Some days, you'll feel you can't make it to the next. Other times, you may feel almost normal.

Here are the general emotional stages you might expect:

• Shock and Disbelief: No one expects a baby to die. At first, the reality of loss tends to be overwhelming and too painful to bear. Shock helps dull the pain.
• Sadness, Anger, Guilt, and Despair: After the reality of your loss sinks in, intense emotions surface. You may feel ill or have trouble eating or sleeping. You may question what you could have done differently, or you may despair that there's nothing you can do to change what happened. It's something you'll live with for the rest of your life.
• Acceptance and Adaptation: Eventually, you'll start to look to the future and new beginnings. Your baby's memory will remain, but you'll feel ready to move on.

Here are some suggestions to help you recover:

Physical Care

• Nourish your body. Eat regular meals (or snack frequently if your appetite is weak). Drink water, juice, and other liquids six to eight times a day. Avoid caffeine and alcohol.
• Get plenty of rest. Maintain your regular bedtime. Wind down with a warm bath, chamomile tea, or other restful activity. If you're getting less than 4 hours of sleep a night, talk with your health care provider.
• Get regular physical activity. Go for a walk, do stretching exercises, or ride your bike. Spend time outside in the sunshine. You probably won't feel like doing much, but as you participate in physical activity, you may find that it strengthens your body and spirit.

Emotional Care

• Talk it out. Talk about your baby with your partner, family, and friends. They may be reluctant to broach the subject. Let them know it is okay to do so. Encourage them to use your baby's name, if you've chosen one. Letting out your emotions is the best way to heal. If you ask for what you want, you're more likely to feel loved—and that's the best medicine to heal grief.
• Write it out. Write in a journal or diary about what you're feeling. Write poems and letters to your baby, sharing everything you'd like her or him to know but didn't get the chance to say.
• Commemorate your baby. Create a physical commemoration of your baby. Make a scrapbook, including your ultrasound picture or footprints from the hospital. Paint a picture. Plant a tree. Whether or not you choose to name your baby, it's important to mark that your child has been a part of your life.
• Relax and meditate. Practice relaxation or meditation, or take a break each day. Find a restful place in your home or outdoors. Meditate on the sunset and the beauty of nature.
• Read. Read books and articles by parents who have endured a similar loss, but don't compare your experience to theirs. Follow your own path.
• Allow yourself time. Keep your baby's things until you're ready to let go of them (if you ever are). This isn't morbid. It's part of grieving. If you've already bought clothes, toys, or nursery items, wait a while to decide what to do with them. Throwing things away won't ease your grief.
• Do not rush into another pregnancy. This is not a healthy way to deal with your loss, no matter how strongly you feel this will help you move on. If you wish to get pregnant again, talk with your doctor and your partner. Be patient despite your pain.
• Seek help. Ask for household help, companionship, and whatever else you need from family and friends. Join a support group. If you feel that your depression or anxiety are worsening or lingering too long, speak with a professional counselor.

Resources

The March of Dimes offers handy information about coping with pregnancy loss: Link opens in a new windowhttps://www.marchofdimes.org/find-support/topics/miscarriage-loss-and-grief

Compassionate Friends provides support for bereaved parents and siblings: Link opens in a new windowhttps://www.compassionatefriends.org/stillbirth-miscarriage-infant-death