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No Matter When it Happens, Loss of a Pregnancy Can Be Devastating

Posted: 07/18/2012 5:52 pm

It is an event in my life that I will never forget. I woke up one morning and after four weeks of nausea, fatigue and strange cravings, I felt "normal," which seemed wrong. Everyone reassured me there was no reason to worry. I'd seen a strong heartbeat at a six-week ultrasound, I'd had no cramping or bleeding, and it is normal for pregnancy symptoms to fluctuate. But I just knew in my gut something was wrong.

Time seemed to stand still over the next two weeks while I waited for my scheduled 12-week ultrasound. Every moment of every day of that period my chest felt tight, and I was filled with anxiety and dread. The winks and nudges and innuendos I got from acquaintances on behalf of my already-bulging belly at a wedding only increased my misery.

The next day my husband and I arrived at the hospital for our first visit with an obstetrician. After several attempts using the doppler, the doctor admitted he could not find a heartbeat. I was now certain how this would end. He said an ultrasound would confirm the situation. I was forced to sit and wait for another few hours in a waiting room full of glowing women with massive pregnant bellies. I wept while my husband sat beside me, uncertain what to do or say.

All I remember next were the ultrasound tech's words "I'm sorry."

I was scheduled for a D&C the next morning since all of the "tissue" had been retained. After a sleepless night, I took the pills I had been instructed to take in order to make the procedure easier. Just over an hour later I was having severe cramping. By the time my husband dropped me at the door of the hospital so he could park the car, I was in so much pain I fell to my hands and knees. A stranger found a chair for me, but sitting offered no relief. My husband found me doubled over in the lobby, and he helped me up to the operating waiting room. By the time a nurse came to prep me, I had gone into shock and my blood pressure had dropped significantly. The nurse shook her head and said I should have been warned that the pills can have this effect. A shot of Demerol finally made the pain more bearable, and I sunk into a haze while they monitored my blood pressure.

I was put under for the procedure and when I awoke, my husband and mother were standing over me and a nurse handed me a cordless phone. The obstetrician told me everything had gone well and unless I had severe cramping or bleeding, I needn't see him again until I was pregnant. No one asked me if I was okay. I wasn't. No one asked me if I wanted support. I did.

This was a major turning point in my life. It didn't make sense to me, and it did not seem right. It is one of the reasons I gave up my former career path, went back to school, and became an infertility counsellor. It made me grow up. It made me realize the importance of family. The death of a child is widely recognized as one of the most difficult losses for an adult, and the age of the child has little impact on a parent's grief.

Nevertheless, the psychological and emotional impact of miscarriage is generally overlooked in our society. I was appalled by a recent question sent to the Toronto Star's Ethics Columnist regarding the ethics of having a funeral for a stillborn child. The person asked, "Ethically, isn't there a problem with creating a 'person' out of this fetus, just to meet the emotional needs of grieving parents?"

Excuse me? People hold funerals for pets; what is wrong with having a funeral for an unborn child? Isn't any funeral partly for the benefit of the grieving? Whether or not an unborn child is legally recognized as a person is, in my opinion, irrelevant.

Miscarriage and pregnancy loss, regardless of gestational age, increases the risk of general anxiety and of particular anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder for up to a year following the loss. Although at least 20 percent of all women experience a miscarriage, unlike with other forms of loss in our society, there are no established rituals to publicly acknowledge the event, structure mourning or gain social support. Research consistently finds that women who have experienced a miscarriage feel that the responses of friends and family minimize the significance of the event and are dissatisfied with the support they receive. In addition, health care professionals also fail to understand the implications and significance of pregnancy loss for women, and in spite of the risks of psychological morbidity do not routinely provide follow-up care to patients.

Those who have not experienced a miscarriage or pregnancy loss may comprehend the grounded meaning of the event, or the specific attributes, elements and activities surrounding it, but they may fail to grasp the valuative meaning of miscarriage, or the personal meaning of the event thought to be understood only by those who have gone through the experience.

Many people admitted having a pregnancy loss after I spoke about my own. Even my own grandmother -- who had previously never told a soul -- told me that she had a miscarriage prior to conceiving her children. During that difficult time following my own loss, it was speaking to others who had been through it themselves that gave me the most comfort.

There is a vast body of literature documenting the significant impact of miscarriage on mental health and recommending that health professionals provide follow-up care to women who have experienced them. While this is indeed critical, it is also important to change the way miscarriage and pregnancy loss is handled outside of the medical community. The existing stigma and lack of understanding is only perpetuated by practices such as announcing pregnancies only after 12 weeks. The reason for this, the high chance of miscarriage in the first trimester, is precisely why this custom should cease. Why should people suffer in silence? Why should they not be given support from their community? Why should they feel shame if a loss occurs? Why shouldn't they hold a ceremony to mark the event and to help them with their grief?

References:

Brier, N. (2008). Grief following miscarriage: A comprehensive review of the literature.
Journal of Women's Health, 17 (3), 451-464.

Brier, N. (2004). Anxiety after miscarriage: A review of the empirical literature and
implications for clinical practice. Birth, 31 (2), 138-142.

Gerber-Epstein, P., Leichtentritt, R.D., & Benyamini, Y. (2009). The experience of miscarriage
in first pregnancy: The women's voices. Death Studies, 33, 1-29.

Nikcevic, A.V., Tunkel, S.A., & Nicolaides, K.H. (1998). Psychological outcomes following
missed abortions and provision of follow-up care. Ultrasound in Obstetrics and Gynaecology, 11, 123-128.

Pinel, J.P.J. (2007). Basics of biopsychology. Boston: Pearson Education, Inc.
Renner, C.H., Verdekal, S., Brier, S., & Fallucca, G. (2000). The meaning of miscarriage to
others: Is it an unrecognized loss? Journal of Personal and Interpersonal Loss, 5, 65-76.

Sigelman, C.K. & Rider, E.A. (2009). Life-span human development (6th ed). California:
Wadsworth Cengage Learning.

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It is an event in my life that I will never forget. I woke up one morning and after four weeks of nausea, fatigue and strange cravings, I felt "normal," which seemed wrong. Everyone reassured me the...
It is an event in my life that I will never forget. I woke up one morning and after four weeks of nausea, fatigue and strange cravings, I felt "normal," which seemed wrong. Everyone reassured me the...
 
 
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HUFFPOST SUPER USER
MMStar
06:28 PM on 08/09/2012
I am so sorry for your loss, and I thank you for being another voice among many sharing a story that will help countless others. I just had my fourth miscarriage at almost 10 weeks, just 2 weeks ago. I have started a blog to discuss what it's like to be among the 1-2 percent of women who experience recurrent pregnancy loss (RPL). www.theyellowblanket.wordpress.com
09:43 PM on 07/27/2012
I've had an ectopic pregnancy and a miscarriage. I think pregnancy loss, especially early pregnancy losses are hard because many people don't really get it. People say stupid things like, you can have more kids, it could be worse, blah blah blah. That doesn't change the fact that some women who have an early pregnancy loss need to grieve, as soon as you find out you're pregnant, you start thinking about the future. About your life, about the baby, etc. Miscarriage is actually REALLY common. There are LOTS of online support groups for pregnancy loss, yet very few people talk about it in "real life."
Why?.....I have no idea!
07:49 PM on 07/27/2012
Thank you for a great article.
06:27 PM on 07/20/2012
There are chaplains who can and will help facilitate ceremonies that honour the grieving process from a miscarriage.

The sermon called "The Spiritual Imperative of Choice" by Rev. Krista Taves speaks about exactly the importance of this choice in the case of a tragic miscarriage. (see link)

http://cuc.ca/ministry/selected-sermons/
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averagezoe
Don't breed or buy while homeless animals die!
05:51 PM on 07/20/2012
The sense of loss really depends on one's perspective. I've had 4 miscarriages, one abortion, and my 18 month old son died in a car accident. While losing a child was traumatic and painful, losing a pregnancy - wanted or unwanted - most certainly was not.
12:43 PM on 07/20/2012
I always look at the comments for blogs like this, and expect to find people refuting it based on their own personal individual experience, and the details of that personal individual experience. I expect to find that the personal individual experience of the commenter is hardly relevant.

I am rarely surprised.
This user has chosen to opt out of the Badges program
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shortguy54
Short, balding, brilliant... (well, maybe not so)
12:24 PM on 07/20/2012
This lady has a PhD in "Exercise Science"? Only in America....
05:50 PM on 07/20/2012
Actually you're wrong. Universities all over the world have departments that study exercise sciences/physical activity and health/kinesiology. It's a multidisciplinary area that covers a broad range of issues related to education, medicine, rehabilitation, sport performance, mental health, psychology, sociology and history.
09:56 AM on 07/20/2012
So how many scrunches do you have to do to get a PhD in exercise science?
11:10 AM on 07/20/2012
You mean crunches? Five hundred, plus five hundred push-ups and five hundred chin-ups. That's all.
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HUFFPOST SUPER USER
alaskan
09:37 AM on 07/20/2012
Why aren't more women talking about it? Because it's personal. Not everyone feels the need to broadcast their lives 24/7. Some people (gasp) can't even fathom joining Facebook.
07:42 AM on 07/20/2012
I also suffered a miscarriage at eight week. I also know something was wrong, (sudden absence of pregnancy symptoms but no cramping or bleeding). However, my fertility specialist, performed a therapeutic abortion where I was sedated. I was spared the physical pain. The emotional pain came after and was supported by those close to
me and other who had miscarried in a helpful compassionate way. We only told a few people since it was so early.I I have sonograms, poems, letters of condolence by those close to me that I keep. It was a child.....we mourn as any
lose of someone we love.
A more compassionate way of caring for a woman losing an unborn child by her health care professional is a must.
06:34 AM on 07/20/2012
My experience was very similar. I was blindsided by my first miscarriage and then infuriated to find it was something people just whispered about. Once I began talking about mine, it turned oit every woman in my office had experienced one, too. Why do people act like it's so shameful? It was one of the most devastating things of my life. I still remember the due date and often wonder about my child that I'll never meet.
11:11 AM on 07/20/2012
I remember my due date too! I'm so sorry for your loss.
01:30 PM on 07/20/2012
Its not from a sense of shame, its from a sense of wrenching, grievous loss - not something many want to talk about perhaps ? My wife and I lost our first baby at three months.
12:00 PM on 07/31/2012
I'm so sorry for your loss. I agree about the crushing loss...a lot of people can't form the words to share such pain nor shoudl they have to. I think the shame part comes when people assume you must have done something to cause the loss. When I told a friend I lost my baby she immediately responded, "What happened?!" as if I had thrown myself down some stairs or something careless and avoidable. Another friend of mine who miscarried was a wreck because someone told her it was probably due to the ginger candy she was eating to help her nausea.
05:25 AM on 07/20/2012
I'm so very sorry for your loss.

And so very angry that people don't seem to care about the pain involved.
I'm the person who breaks down in tears, when my pets die. I'm the kind of person who can't have pet rats, hamsters or mice, because they only ever get to live for two years max. I don't need to handle losing pets that often.

Being that way, I can't even imagine having a miscarriage and how much that would hurt. Anyone who has gone through that has my deepest sympathies.
07:29 AM on 07/20/2012
Please don't compare the possible loss of a hamster to that of child these parents never get to hold. Typical response of "well meaning" people.
01:20 PM on 07/20/2012
I clearly didn't. I said "I can't even imagine having a miscarriage and how much that would hurt."
This indicates, that the difference between my pain and theirs is so great I can't even imagine it.
Get it now?

Please do actually understand what I'm saying, before correcting me.
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HUFFPOST SUPER USER
peachfuzz
my favorite color is pinko
04:31 AM on 07/20/2012
Well I have to wonder how supportive family and friends would be with any health problem you or we have. I know people who lost friends as soon as they got some some chronic health problems. As another poster pointed out, you have to gather more people who are thoughtful and weed the others out. It seems the other parties give no thought to the maternal bonding process that happens with pregnancy. For everyone else the major bonding begins with birth. For the mother and father it is immediate, with normal bonding, but usually the father is more concerned with the mother's health than the baby's, so if the baby doesn't make it, men tend to see it as a natural way to rid off something unhealthy or abnormal. It is easier for men to detach, most of the time. The mother however, has bonded and now has the loss, probably along with feeling inept or defective. It was a much deeper experience & emotional investment for her than for everyone else. You need people who can empathize with loss. They don't even have to know exactly how it feels, but any kind of major loss can clue them into your need to be heard ....so realize that shallow people are not going to be able to serve you well, for these events or much else that involves thoughtfulness.
01:28 AM on 07/20/2012
I also agree that the waiting until 12 weeks to tell practice should end. If someone didn't announce it earlier - and most women want to tell the world, it becomes even harder to discuss the m/c and they suffer even more in silence. I miscarried after telling a lot of people and, after telling them about the miscarriage, felt supported. Mad and sad but supported. After my experience, my sister-in-law conceived and didn't tell me until 12 weeks and I was offended. It made me feel like she couldn't let me see that vulnerable side of herself or couldn't trust me with it. I could tell she was pregnant but I finally heard it through my mother-in-law. I'm still hurt by it.
06:37 AM on 07/20/2012
I'm so glad that you felt supported through your experience if miscarriage. It sounds like you're a person who is very open and genuine in her relationships with others. I agree, people should should not have to hide their pain, but rather have the option to show it and be supported in their loss. At the same time, I wonder if you should reconsider being offended by how your sister-in-law managed her pregnancy. For some reason, she felt that this was the right thing for her to do. People should have the right to make such decisions about their own pregnancies without worrying about others being offended. You cannot force anyone to show their vulnerable side to you, they either feel like they want to show, or they feel like they don't. It may have nothing at all to do with you, it may be all her own needs, but those needs should be respected, especially when it comes to such big life events.
11:13 AM on 07/20/2012
The same thing happened to me with one of my friends. I guess people feel they are protecting our feelings, but I took is her feeling sorry for me and not trusting me.
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BettyBoop200
Left is right
01:06 AM on 07/20/2012
The Japanese have rituals for dealing with miscarriages. The children are called mizu-go or waterchildren. There are temples all over the country with small statues of babies, each representing a miscarriage. They are often surrounded by toys, or wear aprons. Maybe you can look into how other cultures deal with miscarriages in your quest to help women here deal with them.