Pregnancy is often a time filled with celebrations and milestones. Many soon-to-be-parents carefully consider names and imagine vivid details of who their child might be. A miscarriage interrupts the path to parenthood, leaving many individuals feeling a profound loss. The pain of a miscarriage can be managed by grieving the loss, creating meaningful rituals, and seeking a therapist for support.
Common Feelings When Dealing With a Miscarriage
The emotional reactions that an individual may face when dealing with a miscarriage vary widely and may be influenced by contextual factors such as if the pregnancy was known or unknown and wanted or unwanted. The loss can be very significant, especially if the pregnant individual had an emotional attachment to the unborn baby.
If you have ever been pregnant, you likely felt excitement when a loved one threw you a baby shower or you planned a gender reveal party. You may have read books to help you prepare for the new arrival. Perhaps you talked to your baby or played them music. All of these examples help create an emotional bond, a sense of parental identity, and the imagined personhood of the would-be child. The loss from a miscarriage includes not just the loss of the child, but also a loss of identity and the anticipated future.
After a miscarriage, there may be feelings of self-blame or a belief that you were somehow responsible for the loss, even if there was no apparent cause or medical explanation for what triggered the miscarriage. Many individuals are inspired to take special care of their health during pregnancy. You may pay extra attention to the position you sleep in, attending prenatal visits, and avoiding smoking and caffeine.
Messages surround pregnant individuals which suggests they have individual control over their bodies and therefore, responsibility for the pregnancy and unborn baby.1,2 When a pregnancy is lost to a miscarriage, common feelings that arise include grief, sense of loss, devastation, sadness, self-blame, and guilt, although there is virtually no limit to the range of emotions that one experiences.
Miscarriage and Your Mental Health
Miscarriage can impact your mental health, with distress being the strongest in the immediate days and weeks after the loss.2,3 You may experience symptoms of depression, an adjustment disorder, or anxiety after a miscarriage.3,4,5,6 Some miscarriages are so traumatic that post-traumatic stress disorder (PTSD)7 or thoughts of self-harm may develop.3
This is a crucial time to seek aftercare support, clinical therapy, and wellness exams. The emotional pain after a miscarriage can last much longer than the physical recovery or the duration of your mental health distress, sometimes up to years after the miscarriage.
Miscarriage Grief and Stigma
Miscarriage is further complicated by a lack of social scripts for how to deal with the resulting grief. When a loved one passes away, you may receive flowers or a condolence card. You likely have the option for bereavement leave or to attend a funeral.
But after a miscarriage, the appropriate way to respond is less clear. There may be no option to take time off work or hold a ceremony. Knowing how to process the grief and move forward is more of a challenge after miscarriage than compared to other situations of loss.
There is also a stigma that sustains the silence and invisibility of miscarriage. It is customary to avoid or limit disclosing pregnancy early in the first trimester in order to prevent having to share news of a miscarriage in the event that it does happen.
Miscarriage treatments, medical interventions, and language may even be considered too taboo or controversial to openly talk about. The stigma and lack of open support after a miscarriage can complicate the grieving process and leave many affected individuals to cope on their own.
Who Should I Consult for Help?
After a miscarriage, you will likely benefit from a variety of supportive care. Medical professionals are often the first responders or informers of the miscarriage event, but which discipline is appropriate depends on the situation.
One individual may be informed of the fetal death by their obstetrician during a routine appointment. Another may be experiencing signs of miscarriage, such as cramping or vaginal bleeding, and seek help from their doctor or at the emergency room. Regardless of who you initially encounter, any necessary follow-up care should be provided by the professionals who are an appropriate fit for your individual needs.
While medical professionals attend to your physical recovery, a mental health professional can assist with the emotional recovery. Almost any clinician is qualified to help you cope after a miscarriage, although you will find that professionals range on their training and experience with treating this presenting concern.
A counselor with a specialty area in grief and loss, infertility counseling, or women’s issues may be familiar with miscarriage loss, but this is not true for all professionals in those specialty areas, nor is a specialization a pre-requisite for finding a clinician with the competence and ability to successfully address your needs.
If you and your partner are having relational issues after the miscarriage, a couple’s counselor may be another consideration. They can address problems such as incongruent grieving styles or poor or lack of communication, and increase connectivity and support.
How to Cope With a Miscarriage
A miscarriage is a significant life event, regardless of how you felt about the pregnancy. Identifying ways to cope with the experience will help you move forward and not stay stuck in grief. Remember that your story is unique and you must decide how to adapt these guidelines so that they fit you and your needs as best as possible.
Let Yourself Grieve
You have just endured a loss that is very likely to have been physically and emotionally painful. Even those who miscarry an unknown or unwanted pregnancy may still find themselves feeling emotional, confused, sad, or guilty. For those deeply attached to the pregnancy, the miscarriage may be excruciatingly difficult to bear.
There is no right or wrong way to grieve after such a loss. This is a time to be patient and compassionate toward yourself. Identify, feel, and accept your emotions for what they are, rather than trying to shut them out or stuff them inside.
Tend to Yourself
Get in touch with what you need after your miscarriage and follow through on self-care. Self-care is very individual and should include hobbies or practices that allow your body and mind to feel good. You can start with ensuring you are eating well, drinking water, and getting plenty of sleep. If you feel apathetic or even punitive toward yourself after the miscarriage, reach out for help—you absolutely deserve to be taken care of during this time.
Focus on the Facts
You may find yourself analyzing every action or decision you made while pregnant to determine if you did something to cause the miscarriage. Dwelling on these thoughts will only make you feel worse and ultimately do not change the situation. Instead of pondering the “shoulda-woulda-couldas,” stick with the facts that you know. This can help minimize personalizing an event that was out of your control.
Stay Grounded in the Present
After a miscarriage, you may find yourself contemplating both the past (“Why did this happen?”) and the future (“Will it happen again?”). This can easily lead to overthinking and strong emotional reactions. Use mindfulness, deep breathing, or cognitive exercises to redirect your mind back to the present moment. If presence is something you struggle with, or you would like to learn more about these tools, a therapist is a great person to ask for help.
Create a Ritual
It can be very helpful to find a way to memorialize your lost child after a miscarriage. You may participate in a funeral or memorial ceremony for your baby, which can be organized even if you do not have remains to bury or cremate.
Other rituals or memorials that can facilitate healing are planting a tree or plant, grief journaling, creating art, or crafting an object such as a Christmas ornament, stone plaque, or jewelry.8 The idea is to create a space for you to honor what you have lost in a way that makes sense to you and contributes to your healing.
Seek Out Support
The days and weeks after your miscarriage are likely to be a sensitive time. Relying on the support of others can help make your emotional weight easier to carry.
- Your partner is likely walking through the grief alongside you, even if you have different grieving styles or are in different places with your grief. Sharing space in your grief together can create bonding and comfort.
- Family and friends are the people in our lives who usually know how to support us in times of need. They can be a soft place to fall after a difficult miscarriage. It is still helpful for you to communicate how you would like to be supported, as family and friends are not mind readers and your input on how they can help is valuable.
- A therapist or counselor can provide you with a confidential and non-judgmental space to process your feelings and learn coping skills for moving forward. You may also find couples therapy to be beneficial, especially if the miscarriage has caused a rift between you and your partner, or it amplified problems that were present before the pregnancy.
- A support group is typically run by a mental health professional or peer mentor and provides a space for connecting with others who have experienced the same event. A support group can be a place to find camaraderie and friendship in others who know what you are going through. Sharing your story can both normalize your feelings and help others, which is a cathartic experience.
How to Be a Supportive Friend or Family Member
It can be difficult to know how to help a grieving friend or family one after they have a miscarriage. We often have the best of intentions, but miscarriage is a difficult subject to openly talk about and we may be unwilling or unsure of how to approach the conversation. The following tips can help guide your response.
The tone of conversations and comments regarding the miscarriage should always be set by your loved one. Unless your loved one has specifically stated otherwise, assume that their miscarriage was a significant loss that must be approached with compassion and sensitivity. It is true that not everyone experiences miscarriage as a devastating event, but if in doubt, it is always best to err on the side of caution.
Be Prepared for Discomfort
Miscarriage stigma can provoke uncomfortable feelings such as shame, disgust, or embarrassment during conversations. Your loved one may be very emotional, which you might feel unprepared to handle. If they are sharing their story, you may hear graphic descriptions of medical procedures or how the baby was passed. You do not have to have all the answers or know the “right” thing to say. But do understand that sharing space with your loved one may include withstanding strong emotional topics.
Share Your Story
Miscarriage loss is not uncommon; it’s just taboo to talk about. Chances are you know someone who has endured a miscarriage, even if you are not aware of it. If you have a personal story, it can be cathartic for both you and your loved one to share that together. Of course, to whom and when you disclose your story in the context of being a support of your loved one is a very personal decision and should be considered carefully and with compassion.
Balance Giving Space With Encouraging Support
After a miscarriage, you can offer to spend time with your loved one, encourage them to engage in self-care, or help them seek professional support. The grieving process is very unique and your loved one may require a different response from you at different points in time. Focus on inviting your loved one to take care of themselves and to share with you, but respect the pace at which they are most comfortable to take you up on these offers.
Ask Your Loved One How They Are Doing
You may hesitate to bring up the miscarriage or lost child in an effort to protect your loved one’s feelings, but now is the time to take an interest in their well-being. Ask them how they are doing or what they need from you. Your loved one will elaborate as much or as little as they are comfortable with, but you asking at all shows them you care and you see them, which may be just what they need.
Here are some additional tips for what to avoid:
Do Not Police the Grief
You may believe it is time for your loved one to move on, but that is not your place to decide. Comments such as, “Just get over it,” or, “It’s been six months,” will only produce negative feelings for your loved one and perhaps even cause them to pull away. Unless your loved one is unable to successfully function as a result of their grief, there is no abnormal amount of time for them to grieve after a miscarriage.
Do Not Judge
Your loved one may share intimate details of their miscarriage story with you. During these delicate conversations, you may learn that your loved one had to make impossible decisions, some of which might conflict with your religious or cultural views. Keep the focus on supporting them, rather than questioning their decisions, giving a lecture, or offering your opinions.
Don’t Forget About the Loss
A miscarriage can be a life-changing event for your loved one. Take their lead on how to memorialize the loss. Remembering a significant date or displaying a Christmas ornament with the lost child’s name can be a small gesture that is ultimately very meaningful to your loved one.
Miscarriage occurs in about 10-15% of known pregnancies.9 Most miscarriages happen in the first trimester, before the twelfth week of gestation, with only 1-5% of pregnancies miscarrying in the second trimester9 Two or more miscarriages in a row are called repeat miscarriages, and these affect about 1% of women.9
It is important to note that transgender men and some non-binary or intersex individuals can become pregnant and may also be affected by miscarriage.
The cause of a miscarriage is not always known, but chromosomal abnormalities, uterine or cervical issues, infections, or chronic diseases, are potential factors.9,10 Risk factors that increase your likelihood of having a miscarriage include age, smoking, drug or alcohol use, a history of previous miscarriages, certain health conditions, and some prenatal tests, such as an amniocentesis (testing of the amniotic fluid).9
Medical treatment is not required for every miscarriage, but sometimes it is necessary, and may include medication or surgical procedures such as dilation and curettage (D&C).9 The timeline of physical and emotional recovery varies from person to person, and may impact when you choose to start trying again for conception.9,10 Many individuals who have a miscarriage go on to have healthy babies in the future.
For Further Reading
- The March of Dimes is a well-known organization which focuses on pregnancy health and providing information on premature birth and infant death.
- The Miscarriage Association is a charity based in the UK and was founded as a peer support by those who had experienced miscarriage themselves. The organization aims to provide information and support to those affected by pregnancy loss.
- Australian Stillbirth and Newborn Death Support (SANDS) organization runs a parent peer support program. It is a place where a bereaved parent can reach out and find support from another parent who has endured the loss of a child.
- Mother’s Day After a Miscarriage