Pregnancy loss is a broad term that generally refers to the unexpected loss of an infant in the early stages of pregnancy. Whether this loss was through stillbirth, miscarriage, a neonatal death, a failed embryo transfer, or a spontaneous abortion, the experience can be a traumatic life event.
As we experience life events and transitions, we also experience a vast array of emotions. Speaking particularly towards pregnancy loss, often times witnessing such a death can be unexpected and quite sudden. Going through such an experience can leave one feeling shocked, confused, angry, guilty, sad, and in pain. You see, even though you may have lost other family members or friends, you were able to share that grief by talking about it, posting it on social media, and receiving support. But for couples who have are facing a pregnancy loss, they may not received that same outpour of support because it’s a very personal and intimate loss, and not everyone is able to openly share nor might they want to. It’s also worth mention that, although these individuals may not have had a relationship with their infant, the loss can have psychological impacts on parents. To name just a few mental health issues that can arise: depression, anxiety, sleeping disorders, and post-traumatic stress.
It’s important to recognize that there is still an element of stigma associated with pregnancy loss. Even though miscarriage has become so common, it is still so difficult to talk about it. There have been more and more couples who are struggling with infertility or undergoing fertility treatment, yet they are struggling in silence together because it is also something that is still stigmatized in our society. All of this is can be such an isolating experience. Individuals and couples more often than not, try to minimize their emotional response because they may carry feelings of guilt, shame, or simply not know how else to react and process this journey. They struggle with figuring out who they can share it with and how that person may react. It’s difficult because when they turn to the internet for information, they are overwhelmed with information that may or may not be true. Grieving after a pregnancy loss is a very intense and individualized experience. Just imagine, going to the hospital pregnant, and leaving without a child. Of course you are going to be terrified, confused, sad, angry, and in pain.
The grieving process for pregnancy loss can last anywhere from several months to several years, so it is important you receive the right form of support.
Symptoms of grief can include, but are not limited to: lack of energy, fatigue, physical symptoms such as headaches or gut-related issues, not sleeping enough or sleeping too much, overworking or excessive activity, feeling irritable, feelings of isolation, depression, anxiety, feelings of anger, and sometimes questioning faith or religion.
Stages of Grief
A well-known psychiatrist that goes by the name of Kubler-Ross proposed five stages of grief, that we in the therapy world use to break down grief. The five stages are: denial, anger, bargaining, depression, and acceptance. These stages don’t necessarily have to happen in this order, in fact, some may be intertwined depending on the circumstances. It is important to remember that everyone grieves differently. So some individuals may experience all five stages, while others may not.
Denial is usually the initial reaction to the loss. Some individuals may experience this longer than others.
Anger might emerge and may be directed at the deceased, a partner, a close family member, or sometimes even God. You may feel pain or resentment because of the loss.
Bargaining is when feelings of helpless and vulnerability might start to seep in. You might find yourself trying to bargain or make a deal, for example with God or a higher power. Again, this is a normal response to the pain and guilt you may be feeling.
Depression can show up in various forms. Sometimes this through sadness and regret, other times symptoms may be more prominent or last much longer. Either way, it is always a good idea to touch base with a health professional that can offer you the support that you need. Some of the thoughts that may seep in at this time can be harmful and it is best to get help sooner than later.
Acceptance is when the individual has understood that their loved one is gone, and is able to move past anger or denial. They have learnt to make peace with the matter, and try to make space in their lives for happiness and calmness. The individual is able to come to terms with what has happened, and has found a way to move forward.
I wanted to share some coping tools and strategies that can be helpful with the grieving process.
Journaling: journaling has proven to be helpful time and time again. It is actually one of the tools most therapists recommend using, not only when times are tough, but even during the good times! Journaling can really help you work through your thoughts and feelings, and provide you a safe space to organize your thoughts in a meaningful way. It can also make for a learning experience in that it allows you to recognize and observe these feelings and thoughts, and notice any patterns and behavioral outcomes.
Talking to loved ones or finding a support group: this one might be difficult if you do not feel comfortable sharing your loss with loved ones. And that, is completely understandable. But remember, by sharing you receive support, and by receiving support, you start the process to healing. If this is something that you do not wish to share with friends or family members, perhaps look for support groups that you can join and talk about your loss with. It may even help for you to process your thoughts and emotions when you are able to hear or talk to others who have shared similar experiences to you. Sometimes by sharing our stories, not only do we receive support, but unknowingly, you might be giving another individual or couple the support they needed.
Setting realistic goals: these are goals that are specific, relevant, obtainable, and something that is measurable or time-bound so that not only can you hold yourself accountable, but also feel a sense of achievement once you complete them. In a moment where confidence or self-esteem may be shattered, setting and achieving these goals, no matter how big or small they are, can really help.
When to Seek Help!
Research has shown that receiving support for pregnancy loss and taking advantage of grief counselling can reduce mental health symptoms such as long-term depression and anxiety. It is important to understand and accept the reality of the loss. It is important to identify and deal with traumatic experiences. It is important to be able to talk about these sensitive topics in a safe and supportive environment.
Some misconceptions about grief counselling are: therapists will make you forget about the individual you have lost, you won’t experience the pain of grief, it will change you and make you forget your past all together. None of these are true. In fact, grief counselling can not only help you experience the loss, but also can help you to find meaning and purpose as you heal and move forward in life. Sometimes this includes finding ways to celebrate and remember the individual that you have lost.
If you have recently experienced loss or are grieving, it is important to reach out for help. The right professional, such as a counsellor or psychotherapist who specializes in pregnancy-related issues and grief, can help you to understand the stages of grief and loss, can help you to process your emotions, thoughts, feelings, and can help you create a plan to move forward.
Sana Chaudhry is a Registered Psychotherapist (Qualifying) with the College of Registered Psychotherapists of Ontario (CRPO). A large portion of Sana’s areas of practice includes perinatal mood disorders, maternal mental health, and reproductive mental health. Sana uses evidence-based modalities and an integrative approach in order to help her clients receive treatment that is personalized to their unique needs.