Meaningful Grieving After Pregnancy Loss
Understanding Grief : Eleanor Haley/
For further articles on these topics:
We want to welcome Hannah Mirmiran back to 'What's Your Grief' to continue our discussion about grieving after pregnancy loss. Hannah is a Licensed Clinical Social Worker who works as a Psychotherapist at Omaha Integrative Care in Omaha, Nebraska. She has a personal and professional link to grief work as it relates to pregnancy loss and she has generously poured some really awesome information into this post including:
- Information on grieving in a meaningful way
- How to support someone who has experienced pregnancy loss
- Books and online resources
Okay, take it away Hannah...
To continue the momentum of speaking about this subject, this post is a continuation of our series about pregnancy loss. In my first post, the feelings and experiences common after a miscarriage or stillbirth were identified. We focused on loneliness, anger, sadness, and guilt in particular. This post is aimed at providing some helpful suggestions and tools for grieving. Also included are some suggestions for how you can provide support to loved ones in your life who have experienced pregnancy loss.
As the first post discussed, pregnancy loss is unexpected and traumatic. It can be devastating. Unfortunately, it’s also fairly common with estimates that almost one in four pregnancies ends in loss. But just because it happens frequently, it doesn’t make it any less painful when it happens to you. Even if a miscarriage happens early in a pregnancy, it is painful. Pregnancy loss is a significant loss and like any loss, it necessitates a grieving process.
So how can you grieve a pregnancy loss? It’s so different than the death of a parent or grandparent and there are not many prescribed rituals, and yet it is important to grieve. No two losses are the same and no two people grieve in exactly the same way. There isn’t a right or wrong way to grieve, but there are some tools that may be helpful along the journey.
While a loss will obviously be different for a mother who suffers a stillbirth, perhaps just days before the expected due date, and a mother who miscarries days or weeks into the pregnancy, any mother who is pregnant and then learns that the pregnancy has ended unexpectedly and without the delivery of a healthy baby will go through similar feelings. This is about grieving the loss of a child and the loss of a dream, regardless of the circumstances of the loss.
For most people, the six months following the loss of a pregnancy are the most difficult. It’s normal to cycle through a roller coaster of emotions including sadness, denial, shock, guilt, anger, disbelief, and depression over and over. The feelings may change day to day or even minute to minute. The important thing to know is these feelings are all normal and they are not constant. Usually, the intensity of the emotions tends to decrease as time progresses. While these emotions don’t last forever, they are incredibly real and can take your breath away.
If you have experienced a pregnancy loss, here are some suggestions about how you might grieve in a meaningful way.
- Acknowledge that this is a big loss. Women who miscarry early in pregnancy may feel like they should be able to “get over” the feelings of disappointment and sadness because the loss was early in the pregnancy. A very common reaction, but not very reassuring since it just makes you feel guilty about feeling sad which you are feeling anyway. It’s important to acknowledge that regardless of how far along the pregnancy was, or what type of loss you’ve endured, this is a significant loss and you can give yourself permission to grieve. A baby has been lost. This baby may already have a nursery, a crib, a name, and a college savings fund. It’s a big loss.
- Allow yourself to feel all of your feelings. Be sad, be angry, be in shock. Just allow yourself to be where you are. Feel your feelings deeply and know that they won’t last forever. Many women find it helpful to allow themselves to cry. Many of the women with whom I’ve worked have found it incredibly useful to cry in the shower where they have the privacy, freedom, and space to sob, weep, and really be with the sadness. Letting them out gives the feelings some space. Sometimes if you can give yourself permission to cry and feel sad, it makes space for other feelings. I like the analogy of the exploding refrigerated can of biscuits or cookie dough. Once the can pops open and the dough seeps through, you can’t ever stuff the biscuits back in there. If you carefully open the package within the expiration date, you can take out each biscuit in a thoughtful way. It’s way less messy.
- Try not to compare your grief. It’s so easy to compare your grief with the grief of others. This goes both ways. You might try to convince yourself that because your loss was early, you don’t deserve to feel as sad as a woman who has experienced a later loss. Or perhaps you’ve had a stillbirth and find yourself feeling as though your loss isn’t as substantial as the death of a two-year-old. Or maybe you have experienced the death of an infant but you can’t fathom why mothers who have had miscarriages would even feel sad. It isn’t the same. No two losses are the same. Your loss was traumatic and you are sad and that is what matters.
- Take care of your physical needs. When a woman experiences a pregnancy loss, there are many things that happen to her body. While the emotional impact of a pregnancy loss is clearly painful, the physical pain is also significant. Bleeding, cramps, pain, and discomfort accompany nearly every miscarriage and pregnancy loss. Depending on how far along the pregnancy had progressed, you may have delivered the baby or undergone a D&C procedure to remove the fetus. Your body may begin to produce milk, and the hormonal changes that occur as pregnancy ends have a tremendous effect on mood and emotions. Post-partum depression is something that can happen as well. After a pregnancy loss, it is very important to take care of yourself. You may find it helpful to take some time off from work, and depending on your company’s policies, you may be entitled to maternity leave or family leave. It’s important to drink lots of fluid, rest as much as possible, and follow-up with your medical provider for after-care.
- Know you are not alone. Unfortunately, there are many other people who have experienced the loss of a pregnancy and there is a whole community of women who self-identify as “baby loss moms”. Most cities have support groups for pregnancy loss and infant death and these can be a wonderful resource. If your community doesn’t have a group up and running, there is a lot of support on-line. Look for a list of on-line resources at the end of this post.
- Know that everyone grieves differently. Each of us needs support in different ways. Some people need privacy and others need to talk through the experience with many, many people. Some people find it helpful to journal or even start a blog of their own, and others don’t have the patience to write anything. There isn’t a right or wrong way, the important part is knowing what feels best to you and then doing it.
- Reach out for support. Eleanor wrote an excellent post about seeking support. If you share the loss with others, chances are that they will ask you what you need or they may say, “Let me know if there’s anything I can do.” It’s good to have a few suggestions for letting others know exactly what they can do that will be supportive. Suggestions might include help with groceries or dinner, assistance entertaining other children, joining you for a walk or a movie, contacting other friends for you, returning maternity clothes, or just sitting with you while you cry.
- Try and let go of guilt. Guilt is not productive and it’s often a dangerous spiral. It’s very common to try to figure out why the loss has occurred. It’s also common to blame yourself, maybe for drinking that glass of wine before you knew you were pregnant, or for taking an Advil or working out too strenuously. Most likely, there is nothing you did to contribute to the loss. Know that you did all you could do. You can read more about the relationship between guilt and grief here and here.
- Expect some bumps in the road. One of the most inspirational clients I’ve ever worked with lost her son when she was 28 weeks pregnant with him. She so wisely coined the term, “train wreck moments” which she described as “moments when a barrage of uncontrollable thoughts, that you don't see until the last minute, are approaching but you're already traveling so fast toward them you can't find the brakes. And in the end, you know they are going to cause more damage than what you know what do with at the moment, but there is nothing you can do to stop it.” These “train wreck moments” may happen when you find out that a friend or relative is pregnant soon after your loss, or when you see your favorite grocery checker or hairdresser who knew you were pregnant and then asks how many weeks are left in the pregnancy without knowing about the loss. Or when you open your e-mail to discover a message from a pregnancy website congratulating you on making it to the next milestone in the pregnancy. You may be able to avoid some of these moments by unsubscribing from certain websites, notifying professionals in your life, and avoiding certain interactions, but there are often unavoidable train wreck moments. It can be incredibly logistically difficult to make yourself “unpregnant”. Sometimes just expecting that there will be some bumps helps to make them a little easier to endure when they do happen.
- Expect some people to say some stupid things. Unfortunately, in their attempts to make you feel better or to alleviate their own anxiety, some people might say things that don’t feel great to you. You may hear that “this is nature’s way,” or "it was for the best," or "you can always try again,” or “at least you already have one child” or “at least the baby is in a better place now,” or “at least you know you can get pregnant.” Usually, the person who is making the comment isn’t being intentionally cruel but just doesn’t know what to say or do. These comments can sting. In addressing your own grief, you probably won’t have the energy to provide a lot of education or counseling to others about why these comments don’t make you feel better, so it’s usually helpful if you just say, “thank you” and then decide whether you’d like to address it at a later point.
- Limit your exposure to Facebook. After you’ve experienced a loss, a glance at Facebook can be like looking at a perfectly airbrushed album of the picture-perfect lives of others and a glaring reminder that others have exactly what you don’t have and desperately want. Sometimes just seeing a pregnancy announcement or ultrasound picture can send you running for the ladies' room while sobbing. If many of your Facebook friends are expecting children, might be likely to announce pregnancy, or frequently post baby pictures, you may want to temporarily block those friends so you don’t have to see pictures that might be upsetting. Some people find it helpful to take a social media sabbatical for a period of time until the painful feelings begin to decrease in intensity. It can also be helpful to apply the old adage that we often “compare our insides to others’ outsides” and to remember that we never really know what is going on for another person based on their Facebook wall. Chances are that even that perfectly-airbrushed friend has experienced loss or hardship at some point.
- Say goodbye: There isn’t really an official protocol on how to appropriately recognize the loss of a pregnancy. And yet, at some point in your grieving process, it may be helpful to do something to recognize the loss. Deciding to honor your loss with a ritual is a very personal decision and there are many possible options. Some parents choose to hold a funeral or memorial service for the baby. Others choose to send out birth announcements with information about the loss. For parents who experience an earlier miscarriage, they may find it helpful to recognize the loss in a more personal way, perhaps purchasing an ornament or piece of jewelry or releasing a balloon. Others may choose to plant a tree or flower in memory of the baby, offer a monetary donation to a meaningful organization, or provide a book or other gift to a church, library, or school. Such rituals are concrete actions that can help give the loss meaning and serve as a way to honor your own grief. Many people also find it helpful to create a memory box filled with memories from the pregnancy. These might include pictures, ultrasound images, a pregnancy test, a list of potential names, and perhaps a letter each parent writes to the baby. I’m a huge proponent of writing. Journaling and letter writing can be very effective tools in the grief process.
- Take care of yourself. Self-care is critical for physical, emotional, and spiritual healing. Physically, it’s important to take care of your body and ensure you are healing. Follow-up with your healthcare provider as needed, drink water, walk, rest. When you are ready, you may find it helpful to try yoga or other gentle exercises. Or you may find it very helpful to engage in more strenuous activities like running when you have been cleared by your doctor. I know that as a therapist, I’m biased, but I truly believe that everyone can benefit from counseling and support from a third party. Especially if you are struggling with sadness, guilt, and anger and these feelings aren’t seeming to decrease with time, working with a grief counselor, therapist, chaplain, and/or psychiatrist can be very helpful. Depression is common after pregnancy loss and it’s important to address it early.
Perhaps someone close to you has experienced a pregnancy loss and you’re wondering how you can be supportive. Maybe you were also connected to this pregnancy as a grandparent or aunt or uncle. Or maybe you and your best friend were pregnant at the same time and now one of you has experienced a loss. These are all tough positions and it’s important to acknowledge that you may also be grieving. What are some ways you can offer support?
- Acknowledge the loss. If you learn that someone you care about has experienced a pregnancy loss, the first step is to recognize it. Reach out and let the person know that you are sorry for the loss and then offer something that you know you’ll be able to provide. Try to offer something specific that is doable for you. That could be taking your friend out for tea, bringing over dinner, or just sitting and listening.
- Listen. Often, parents who have lost a pregnancy want to talk about the loss, to talk about the baby. In the early stages of loss, it can be incredibly important to have someone sit with you, listening attentively and acknowledging your feelings.
- It’s okay to say that you don’t know what to say. None of us are born knowing exactly how to support a grieving friend. Sometimes the most honest thing is the most helpful. Saying, “I know you are hurting and I feel helpless. I know I suck at this, I want to help but I don’t have a clue of what to say or do” might incredibly well-received.
- Don’t give unsolicited advice. When your loved one hurts, it is only natural to want to make her feel better. I think our natural inclination is to want to make it better, stop the hurt, put on band-aids, and take away the pain. Unfortunately, after a pregnancy loss, there isn’t anything anyone can do that will take away the pain. The pain will subside with time, but it needs space. The hardest but most important job of supporting someone in pain is to just sit with the pain. It’s common to want to offer some suggestions like “you guys should try again soon”, or “I think if you come to church more often you’ll feel better”. A grieving person may hear those words and interpret them as advice that they are doing something wrong, and that’s not a great way to feel in the midst of a loss.
- Don’t try to give meaning to the loss. In the same vein of unsolicited advice is unsolicited meaning. Trying to find meaning in any loss is normal. Chances are that your loved one is searching for meaning and asking many why questions. She may want to talk about these with you and that is great. But it can be hurtful if someone else tries to suggest some answers without prompting. These might include, “the baby is in a better place”, “I’m sure there was something wrong with the baby”, “sometimes this is nature’s way”, “God needed another angel”. These sayings can be hurtful and frustrating because they may not be true and they don’t tend to address the hurt and pain that the parent is feeling right after the loss. Yes, there might be another baby someday and this baby might be in a better place, but right now, that parent only wants this baby here on earth and is grieving the loss of this baby.
- Understand if there is distance. If your loved one isn’t responsive to your attempts to reach out, give her a little time and space. The parent who has lost a baby often goes through a period of shock and may be experiencing some post-partum depression. Also, if you are pregnant or have a new baby, it might be very difficult for your loved one to be around you because she may be experiencing real feelings of jealousy. This is very normal and it’s okay to acknowledge that this might be happening. If you are blocked, defriended, or unfollowed, it’s okay—it’s usually not about you and about the other person taking care of herself.
- Don’t disappear. Even if your friend doesn’t seem receptive, keep reaching out. Send regular notes, texts, or e-mails, or call every few weeks to check in.
- Know that there isn’t a timeline. Everyone grieves differently and there isn’t an end date when the feelings go away. The loss is forever, but the feelings change. For many women who have experienced pregnancy loss, the physical healing happens before the emotional processing, and the grieving process can take many weeks and months. Be patient and be prepared to settle in for the long haul.
- Ask about the baby. Many bereaved parents want to talk about the baby and find it comforting to share the hopes and dreams they had for this child.
- Remember the big days. Recognize Mother’s Day and Father’s Day. Make a note of the anniversary of the loss to recognize it in future years. If you are aware of the expected due date, recognize the day when it approaches with a card or phone call.
- Take care of yourself. Supporting someone through grief can be draining and overwhelming. Make sure you are doing your own self-care and getting your own needs met.
Here is a list of additional resources that may be helpful:
“Empty Cradle, Broken Heart: Surviving the Death of Your Baby” by Deborah L. Davis
“Grieving the Child I Never Knew: A Devotional Companion for Comfort in the Loss of Your Unborn or Newly Born Child” by Kathe Wunnenberg
“What Was Lost: A Christian Journey through Miscarriage” by Elise Erikson Barrett
“Empty Arms: Coping After Miscarriage, Stillbirth and Infant Death by Sherokee Ilse
“Surviving Miscarriage: You Are Not Alone” by Stacey McLaughlin, PhD
“I Never Held You: Miscarriage, Grief, Healing and Recovery” by Ellen DuBois and Dr. Linda Backman
For Family or Friends:
“How can I help? Suggestions for People Who Care About Someone Whose Baby Died Before Birth” by Martha Wegner-Hay
“Stuck For Words” by Doris Zagdanski
“A Silent Sorrow: Pregnancy Loss - Guidance and Support for You and Your Family” by Ingrid Kohn and Perry-Lynn Moffitt
For more articles about pregnancy loss, click on the following links:
16 Comments on "Meaningful Grieving After Pregnancy Loss"Click here to leave a Comment
Arnie April 2, 2014 at 8:58 am
Litsa- I read this post about pregnancy loss and am anticipating that an acquaintance of mine will have a miscarriage or the birth of a significantly deformed child. If the latter occurs, should I expect her to experience a “loss” and subsequent grief, and if so, how does the advice for being a grief supporter differ in that situation vs. supporting her after a miscarriage? Somehow I think the answer may be one of those “it depends” answers, but I would like to be prepared to help her properly. Thank you for your thoughts.
Litsa April 2, 2014 at 10:28 pm
Hey Arnie, you are right, it does depend! This is a really good question. I think the most important thing is to take your cues from her. She will probably be feeling an enormous range of emotions, from feelings of joy to feelings of loss and everything in between. Don’t assume anything about what she is feeling and wait for her to share with you. Caring a child with disabilities can be extremely challenging and overwhelming. It can also be very isolating. Anything you can let her know you will be there for her will be appreciated. In the end, you actions will mean the most. Be there as a friend and supporter for the long term. Don’t pretend everything is easy or normal, but do the things you would do for any mom — hold her baby, buy her a gift for the baby, and celebrate the joy while acknowledging that you know it won’t be easy and you’ll be there for her. As I am writing this, I am struck that there are similarities in what you may offer a griever and someone who has just had a baby! Offer to baby sit, help with shopping, help with the other children (if there are any) when they have doctors appointments, etc. Just seeking advice and thinking through what you should do is a sign that you are a good friend and caring person – I am sure that will come through in whatever action you take.
Dipika October 21, 2013 at 10:37 am
Totally true about “expect some people to say stupid things.”
Dr. Joanne Cacciatore June 11, 2013 at 9:32 am
Hannah- thank you. Deep bows.
Litsa June 11, 2013 at 8:33 am
Thanks for all the thoughtful comments! The language around loss is so difficult because so many terms and phrases simply seem insufficient to reflect the depth and complexity of loss. As passionate as Joanne and many others are that ‘pregnancy loss’ minimizes the devisistation of losing a baby by implying that it was a pregnancy that was lost, rather than a child, there are countless others who are angered and offended by the terms stillbirth and miscarriage. Though there are many concerns cited with all these terms, the most common we hear are that miscarriage implies fault and causes many women to feel guilt that they somehow failed. We hear concerns that it doesn’t convey the devastation of a death of a child. For stillbirth we again hear many women, online and in conversations, voicing their frustrations with this term– some saying it is too clinical, others saying it doesn’t confront the depth of the loss by not using the word death. We hear and read frustrations regularly that any and all of these phrases are perceived by others outside the grief community as a “lesser” loss.
What we know is that language is crucial because it impacts us and our experiences deeply, but that we all experience language differently. What we appreciated about Hannah’s post, knowing any of these words runs a risk of offending, was that she found the strength and courage to write a heartfelt and useful post based on her experience, using the words that resonated with her. We know here at WYG that grief is so different for every individual. Every phrase and every post will not be for every griever. The best we can all do is share our feelings, experiences, advice and feedback in constructive ways that support the grief community as a whole. This is how we learn. This is how we grow.
We are proud to be here to give a voice to grievers and professionals alike. We believe that language is dynamic and we redefine it every day. For so many years miscarriage, stillbirth, pregnancy loss, perinatal loss, and any other term for the death of a child before or during birth were somehow ‘lesser’ deaths with ‘lesser’ grief. Every time a woman stands up shares the story of the death of her child she changes the narrative and the culture. She says that these words are not of a lesser loss, but rather that these words encompasses the loss of a child and add the unique and unimaginable pain of that loss occurring before birth. These losses are just as real and these words should carry the same depth and power. The more we use them the more power we give them. As a grief community we are in this together, supporting each other, and changing the culture and language around grief one day at a time. We are grateful to Hannah, Joanne, Jeannie, Whitney, Mom of One, and every other mother out there giving voice to this loss.
As Mom of One says, this needs more discussion and exploration, because the more we discuss the more we understand and empower one another. Joanne, should you or anyone else wish to guest post on this topic we would love it. Please send us an email.
Though sometimes comment threads on the web can bring out a passion around of grief and loss that can feel divisive, let us not forget that we are all in this together!
We would love for others to share their comments and experiences around this topic of language. There is no doubt it is an important one.
Hannah Mirmiran June 11, 2013 at 7:10 am
I appreciate all of the thoughts and feedback. I am sorry that some readers found the language offensive. I understand the concerns and agree that still birth is not simply the loss of a pregnancy. I understand the concerns regarding the language used, please accept my apologies and my heartfelt sympathies for each reader who has lost a child, regardless of the age or reason.
Sarah Bain June 11, 2013 at 10:32 am
Thank you Hannah.
Jeannie Jordan June 11, 2013 at 12:23 am
Why can’t we simply say “the baby’s death due to stillbirth, miscarriage” instead of pregnancy loss. My son was full term, stillborn on his due date, no reason why found. He was a beautiful, complete, still newborn – who never took a breath outside my womb. He lived inside me – even now, 5 years later, when I think about it, I can still remember what it was like to lay on the bed in the extra bedroom and feel him move.
He wasn’t a pregnancy loss. I lost him because he died. I understand what Dr Cacciatore is saying, because my Daniel was a child, a much wanted and now MISSing child. My son died. While I understand not wanting to “argue over semantics” – it is important to recognize that mothers need to have the recognition that their BABY died – they didn’t just lose a pregnancy. I attended a seminar by Dr Alan Wolfelt tonight – and I shared how someone had told me that “well, at least you never go to know your son when he was alive (outside of the womb they meant) – otherwise it would have been much harder to lose him. The entire room of over 100 people gasped. Words really do matter sometimes. Overall this was a good article – but I will say that I was definitely “turned off” and if I had read this early in my grieving process – and kept seeing the death of my son referred to as a pregnancy loss. For many people, words do matter – as was evident by all the platitudes that people shared in the seminar I went to tonight (which was grief for all kinds of relationships/reasons)
Sarah Bain June 11, 2013 at 10:58 am
(((Jeanne))) in loving memory of your beautiful son.
Whitney Wright MS,RD,LMNT,CNSC June 10, 2013 at 10:14 pm
Joanne, while I am very sorry for your loss, I feel you are confusing pregnancy loss, miscarriage, and still birth with the topic of loss of a child. I am a professional as well and a woman who has experienced pregnancy loss with an ectopic pregnancy and miscarriage and I feel that this is a very well written, helpful, and well intended article.
Dr. Joanne Cacciatore June 10, 2013 at 11:00 pm
I think you may be confusing things, actually. The loss/death of a baby to stillbirth is the loss/death of a child and research supports this both physiologically and psychologically. The inclusive nomenclatural mischaracterization of stillbirth as “pregnancy loss” rather than the recognition that stillbirth is the loss of a child, as you say, is offensive to me and to many other women. Should you wish to read some empirical articles to clear up the confusion feel free to peruse my many published articles here:
Whitney Wright MS,RD,LMNT,CNSC June 11, 2013 at 12:02 am
Joanne, I feel for you and am very sorry that you feel the need to argue over semantics.
Mom of One June 11, 2013 at 12:38 am
Language is powerful and can influence culture. I wholeheartedly agree with Joanne.
In fact, may I go further to say that using the euphemism of ‘pregnancy loss’ to describe stillbirth is anti-woman. I have experienced both a pregnancy loss (ie. miscarriage) and the death of my full-term baby at birth (ie. stillbirth)–two vastly different experiences. In fact, I was offended when offered to join a Pregnancy Loss Support Group.
To categorize both experiences as a pregnancy loss is significant and has huge implications. This discussion needs further exploration and debate, rather an attempt minimizing its importance by labelling it as just an exercise in semantics.
Sarah Bain June 11, 2013 at 10:57 am
Mom of One, I am so sorry about the death of your baby. Thank you for being courageous and speaking of your grief.
Sarah Bain June 11, 2013 at 10:30 am
“Confusing pregnancy loss, miscarriage, and still birth with the topic of loss of a child?” WHAT?
My child, my daughter, my heart, was stillborn. She, Grace, was NOT a loss of a child you imply? I find this so offensive and with all of those letters after your name, I have to say, shame on you. I hope that no mother ever in your care hears you say “confusing still birth with the loss of a child.” Grace was my child, she was my daughter and she died right before birth. To claim otherwise, is simply short-sighted, ignorant and quite frankly potentially damaging to so many grieving parents. I have had a miscarriage and a stillbirth and while I did grieve my miscarriage, it was vastly different then the death of my child. My child died. She was not and will never be a ‘pregnancy loss.’
Dr. Joanne Cacciatore June 10, 2013 at 2:45 pm
Thank you for the heartfelt and well-intended article.
However, as a woman whose daughter died during childbirth at full term, I am deeply offended by the reference to my child’s death as a pregnancy loss (I did not lose a pregnancy and a pregnancy did not die). Yes, the death of a newborn is indeed a “big loss” – as big as any child’s death, and as helpful as some of the information here may be (citations and references would be nice), I cannot promulgate this as it does not accurately reflect the truth of many mothers whose babies died during or just before birth: the loss of a baby is not the loss of a pregnancy.
While I have many roles in the field of traumatic grief (academic, researcher, clinician), I write this not in any of those. I write this as a woman who gave birth to a little girl, who died only 15 mins before birth on her due date, and who- 19 years later- still misses and grieves for my precious child.
She never was and never will be a “pregnancy” loss.