Miscarriage is such a widespread occurrence that the impact is often minimised, but it was your baby that didn’t survive, your future that didn’t come true. Your grief is real.
Despite being so common, miscarriage is also paradoxically shrouded in secrecy; people don’t talk about their experiences, and often don’t inform friends or family if they experience a pregnancy loss, leading others to believe miscarriage to be rarer than it really is. So, when it happens you feel alone and it’s hard to make sense of your feelings.
Miscarriage grief and trauma is unique and misunderstood. Here’s my take on the reasons why, and ways to help yourself cope after loss, including miscarriage counselling and therapy.
1. Miscarriage is disenfranchised grief
Disenfranchised grief is grief which is not openly acknowledged, publicly mourned, or socially supported1. After a miscarriage there are few memories to hold onto, especially if you haven’t had the opportunity to ‘see’ your baby in scans or feel them move. You don’t get to experience the usual public processes and rituals associated with mourning, such as condolences cards, receiving a death certificate, or holding a funeral.
Often miscarriage happens at a time where not everybody knows you were pregnant, and you might not want to disclose the pregnancy in order to disclose the loss. People who do know might not understand how you feel and may even invalidate your distress with comments like ‘thankfully it was early’ or ‘at least you can get pregnant’; making you feel that your grief is excessive.
This disenfranchised grief makes it much harder to mourn the loss of your baby in a healthy way. If you are feeling this way, miscarriage counselling can be a secure space, and an outlet for your emotions, to help you to process your grief safely.
2. Miscarriage grief is not related to how pregnant you were
It is a common misconception that women experience less grief if their loss was early in pregnancy. In fact the grief experience is not consistently determined by how long you were pregnant, but rather by how attached you were to the idea of the pregnancy as a child and to the conceptualisation of yourself as a mother. Even if you never saw your baby, you knew that they were there, growing inside of you, and you formed a bond. From the moment you found out you were pregnant you were a mother to this baby.
When you have a miscarriage, not only do you lose your baby, but with that you also lose your hopes and dreams of the future – the plans you made are derailed and the life which you were headed towards is changed.
3. Miscarriage is reproductive trauma
A significant number of mothers who’ve experienced miscarriage fulfil the diagnostic criteria for PTSD, moderate to severe anxiety, and depression. Distress which is still evident 9 months after the loss2.
Despite modern overuse of the term, trauma is a neurological response to an overwhelming event. Trauma isn’t about what’s happened, it’s the imprint it leaves on you and your body. There may be elements of miscarriage which feel overwhelming and result in trauma symptoms, such as involuntary remembering, nightmares, feeling on edge, negative beliefs about yourself as failing or being responsible, or avoidance. Grief is a normal process and one which is healthy to progress through; trauma can impede that process and stop it from moving forwards, but thankfully it is treatable.
In the first few weeks following a miscarriage you may find that you are processing what happened at a normal pace – but if the processing takes longer you may be dealing with trauma. EMDR therapy and CBT are both excellent for treating trauma, and can both be provided here at Better Beginnings. If you get in touch regarding miscarriage counselling, I would be happy to discuss both therapy types with you.
4. Miscarriage distress is connected to ‘motherhood failure’.
Miscarriage can happen for many reasons – and often the causes are never established – but you might still believe it reflects upon you and your body. You can fear your body is broken, that it isn’t doing what other women’s bodies do; that which they even take for granted. This is made worse if, for example, you have been trying to conceive for a long time. Miscarriage counselling can help to manage the burden, but you may still find it heavy.
Matrescence3 is a way of understanding the huge changes a woman goes through in becoming a mother. Matrescence doesn’t start in pregnancy but starts as soon as you imagine yourself as a mother, which can be many years back or even in childhood. Miscarriage is a roadblock in this transition, leaving women feeling in limbo between who they were before and who they imagined themselves becoming as a mother.
Society views womanhood and motherhood as inextricably linked, and it can feel like women’s value is determined by where they are in relation to their role as a mother. In other words, society tries to tell us that good mothers don’t ‘lose’ babies, and as a result, many women have a sense of having failed this first test of motherhood. You may never have thought about cultural messaging like that before now, but it is insidious messages like this which contribute to women’s distress and make recovering from a miscarriage harder.
5. Miscarriage grief is affected by how you feel about your body
Pregnancy loss connects women with fragility and vulnerability. This is made worse if you have already had experiences of your body as vulnerable, such as experiencing sexual or medical trauma. The meaning you made of those experiences can impact your experience of miscarriage, changing or compounding its effects; perhaps making it feel more linked to physical vulnerability or inadequacy, and adding to distress after miscarriage. Miscarriage might also re-expose you to triggers from earlier traumatic events, contributing to trauma symptoms.
This is precisely why it’s so important to have an individualised approach in miscarriage counselling or therapy, what psychologists call a formulation, especially where there may be earlier traumatic events rippling through and colouring your experience of baby loss.
6. Miscarriage grief resurfaces around anniversaries and celebrations.
Anniversaries are hard when dealing with any kind of grief, but they can be particularly painful occasions following a pregnancy loss. Especially seeing other babies following the same timeline of development that your baby would, bringing you closer to the lost potential of your baby.
Those who have suffered a miscarriage often feel the grief repeating again at anniversaries, or any holidays or occasions linked to family, motherhood or children, sometimes unexpectedly with no way of knowing in advance which events will be re-triggering. You may experience resurgences of grief around Mother’s Day, birthdays, or Christmas, moments which are supposed to be celebrations but which in fact connect you with what life should have looked like if your pregnancy had continued.
7. Partners experience miscarriage grief too
It is often overlooked, but partners experience miscarriage grief as well. They grief may manifest itself differently – they may have a different set of emotions, feeling further removed from the physical experience but wishing they could have been more connected to the baby, as well as wanting to protect their partner from the loss, and finding very few spaces where their feelings are acknowledged or taken seriously. This can be a painful combination, and it’s important to acknowledge that their grief is no less real and they might also benefit from miscarriage support or counselling.
8. Miscarriage grief can continue even after the subsequent birth of a healthy child
You might have imagined that having a baby would repair the grief of baby loss, and often mothers are surprised when this isn’t their experience. This wish is completely understandable, but a subsequent baby is not a replacement for the baby and future you lost. Pregnancy after loss can be particularly fraught with anxiety.
Even when a new baby arrives the anxiety and fear of loss might continue, colouring your experience of mothering in an unwanted way. It’s true that when you’ve been faced with your own human fragility early in your journey to motherhood, finding that freedom to be an ordinary imperfect mother is much harder. Parenting a baby can be a very tough job with strong emotional highs and lows, but historic baby loss invites a mistaken belief that you ‘should feel grateful’ for the baby you now have, putting a barrier in the way of expressing any sadness or anxiety and interfering with your ability to seek help.
How to cope after miscarriage
Here are some ways you can fortify yourself after miscarriage, and help you navigate a world which doesn’t acknowledge baby loss as it should.
The right support can help
Find spaces to talk. Safe spaces, meant for sharing. Be wary of conversations with people who might minimise or discredit your experience. Often early miscarriage happens at a time where not everybody knows you were pregnant. That you’d have to disclose the pregnancy to disclose the loss and you might not want to do that.
You might find it helpful to hear other’s stories. Social media can help you connect with people who have travelled this road before you. People who can look back and let you know that it’s okay and they survived it. They can share knowledge and coping strategies that helped them and might help you.
However, if you notice that you feel worse learning about other peoples’ traumatic stories, then consider finding a professional space for miscarriage counselling or therapy. This should be a space where you can feel comfortable someone isn’t going to meet your story with telling a story of their own.
Miscarriage counselling with a qualified perinatal psychologist can provide you with a soft place to land and make your recovery a much smoother and healthier experience.
If you were at a point where you were ready to be a mother perhaps you can turn some of that nurture on yourself. Be compassionate towards yourself in exactly the same ways you would when your grieving any other loss. Be gentle with your body and your soul. If you can’t do that for yourself quite yet, is there someone you can depend on to nurture you whilst you weather the storm?
Create ways of staying connected to the lost baby
Create a space for this baby to exist going forward, a way of remembering which acknowledges the relationship you had with them. This could be a day to remember in your diary, a space in your home, a ritual or a tradition that you create. It doesn’t have to be grand or complex, but it can be very comforting to know that you are still connected to them and a way of expressing your love for them.
It might also be reassuring to know that there are not only psychological changes in early pregnancy, but also permanent biological changes. By the process of Foetal Micro-chimerism, babies’ DNA passes into a mother, and, from as early as 4-5 weeks of pregnancy, cells can be found in the mother’s bloodstream, organs and even her beating heart4. For many women it offers some comfort knowing you are in-fact forever connected to your baby.
If you would like to talk about miscarriage counselling, don’t hesitate to contact me. I am a highly experienced clinical psychologist specialising in the perinatal period, including miscarriage and baby loss, birth trauma and perinatal depression.
If you would like to arrange an introduction call, you can do so on my Contact Page. I would be happy to help! You can also find a free guide on that page which may help with anxiety after a miscarriage.
- Doka, K. (1999). Disenfranchised grief. Bereavement Care, 18(3), 37-39
- Farren J., Jalmbrant, M., Falconieri, N., Mitchell-Jones, N., Bobdiwala, S., Al-Memar, M., Tapp, S., Van Calster, B., Wynants, L., Timmerman, D., & Bourne, T. (2020). Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. Am J Obstet Gynecol. Apr;222(4):367
- Raphael, D. (1973). The Tender Gift: Breastfeeding. Prentice-hall.
- Boddy, A., Fortunato, F., Sayrs, M.W., Aktipis, A. (2015). Fetal microchimerism and maternal health: A review and evolutionary analysis of cooperation and conflict beyond the womb. BioEsseays, 37(10):1106-1118