Emotional Healing after Miscarriage

Hopes, dreams, pride, excitement. It’s all part of the pregnancy experience for most women. However, when that experience is interrupted by a miscarriage or stillbirth, women can feel bereft and emotionally untethered.

Over one million pregnancies end in miscarriages or stillbirths each year, according to the Center for Disease Control (CDC). What’s less common is women and their families getting the emotional support they need. When a pregnancy ends early, society tends to forget that the family may have already bonded with their baby. They may have chosen a name and outfitted a nursery. Without the proper support, they can feel misunderstood and isolated in their grief.

“When it happens very early on, people worry they’re going to say the wrong thing, so they may say nothing at all. Women and their partners often don’t know how to approach it, so you can’t expect others to know how to deal with it,” says Nicole Mavrides, M.D., a psychiatrist at the University of Miami Health System. She encourages women and their partners to “be as honest as they’re comfortable being” when people ask how they are.

Parents experiencing the loss of an infant may feel shock, embarrassment, anger, and guilt. A woman who miscarries may wonder if she could have prevented the loss. “It’s rarely caused by something people do. The real reason a pregnancy is not viable has to do with a genetic component,” Dr. Mavrides says.

Fortunately, attitudes are changing. “Celebrities are talking about miscarriage and infertility on social media. It’s gaining more acceptance as a topic we can talk about,” says Dr. Mavrides.

How can you navigate grief?

So how do you cope with the emotional tsunami of a sudden loss? In simplest terms: feel your feelings.

“If you allow the grieving process, you’ll be much healthier overall,” says Dr. Mavrides. She encourages patients to seek medical advice and to recognize and understand the five stages of grief identified by psychiatrist Elizabeth Kübler-Ross, M.D.:

Denial

This stage softens the blow of grief after a miscarriage, allowing time to process our shock and disbelief.

Anger

Anger, like denial, is normal. You may be angry at yourself, at the god of your understanding, at the randomness of your loss. Anger gives us something to hold onto when we feel untethered by loss. Expressing anger in healthy ways helps us move forward.

Bargaining

This stage may involve regret or blaming yourself or others.

Depression

Like anger, deep sadness is a natural reaction to loss. Depending on the depth of your depression and how much it affects your ability to function, you may benefit from speaking to a mental health counselor.

Acceptance

With acceptance comes some relief. You find yourself asking, “How do I move through and past this event?”

Recognizing the stages is one thing. Navigating them is another. Remember – grief is not linear. You won’t necessarily move through the stages sequentially. You may skip a stage, or you may experience a stage that’s uniquely yours. That’s okay. Grief, like life, is messy at times.

How to recognize postpartum depression

Hormonal changes may occur after a miscarriage or stillbirth. “The worst symptoms usually occur within the first month or so postpartum. If you find yourself not functioning, not getting out of bed, sleeping too much or too little, not going to work, it’s important to catch it. Postpartum depression is a true emergency,” Dr. Mavrides says.

Make an appointment to talk with your obstetrician. Discuss your feelings and symptoms and ask for a referral to a professional counselor. Women with severe postpartum depression can benefit from antidepressant medication, one-on-one therapy, or methods such as cognitive behavioral therapy and emerging treatments. If you’re concerned about your partner, ask if you can make an appointment for her and accompany her during the visit.

The gender gap

Your version of emotional healing may differ from your partner’s, especially if he’s male. Men typically experience the loss of an infant differently from women, whether for physical, hormonal, or cultural reasons. “Guys don’t have the same hormonal reactions as women. They may have the same feelings but a different intensity. Whereas women experience an immediate loss, guys may fear future loss or may want to fix the situation,” Dr. Mavrides says.

All that’s needed, Dr. Mavrides says, is to experience the loss together. Use this experience to strengthen your relationship. Understanding that different genders grieve differently will help you practice patience and compassion.

Recovering from a miscarriage or stillbirth takes time.

Be patient with yourself as you heal your body and your heart. There are many ways to find your way back to wholeness:

• Journaling.

  Dr. Mavrides says it is sometimes easier to put emotions and feelings on paper. “A journal can be an outlet for your grief.”

• Ask for help.

  Allowing others to help with chores gives you more energy and time to recover physically and emotionally.

• Move.

  “If your doctor approves, get some exercise.” Be gentle at first – a simple stroll around the block, a few minutes of yoga or something similar.

• Find your tribe.

  “Find others who have gone through this experience. There are miscarriage support groups that meet in person and on Facebook.” Resources: Nationalshare.org/florida/  and Starlegacyfoundation.org/support-groups/

• Talk to someone.

  See a therapist, pastor, or rabbi.

• Be here now.

  “Mindfulness activities, even for five or 10 minutes, are very centering.” Try a guided meditation, set a timer for concentrated quiet time, or spend time in nature without your phone, just focusing on your surroundings.

Any healthy coping mechanism that worked for you before is good to reinstate.

How to support grieving parents

Actions speak louder than words when you’re offering support after a loss. Dr. Mavrides reminds us that we don’t have to fix the pain your family members feel, but we can help in other ways. “Give them a hug. Sit with them on the sofa and watch TV. Make a meal or do the laundry. Offer to pick up their other kids after school. Send a text saying, ‘I’m here for you.’”

Another way to honor parents is by making a memory. “People can give the woman an item that acknowledges the baby’s life – a bracelet, necklace, ornament, angel wings, or perhaps framing an ultrasound picture – anything that creates a connection to the baby.”

What’s not helpful are statements like, “Don’t worry, you can get pregnant again,” or “It’s God’s will.”

The family may need your compassion, not just immediately after a loss but in the future. “If they try to get pregnant again, they may need your support to overcome fear,” Dr. Mavrides says. Encourage them with reminders that many women who experience miscarriage or stillbirth go on to have a full-term healthy pregnancy in the future.

Whether the loss was your own or someone else’s, healing and hope can spring from simple acts of kindness and compassion.

Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Tags: Dr. Nicole Mavrides, emotional well being, grieving, losing a baby, parents mental health