The Silent Lonely Grief of Early Pregnancy Loss
Megan Bousquet, MA, ATR, LPC
There exists a collective cultural understanding to wait to share a pregnancy until after three months, largely driven by the fact that eighty percent of miscarriages occur during the first trimester.
Unfortunately, this leaves many women left alone when they experience a miscarriage. The majority of women lose a pregnancy before they have ever even told anyone that they were pregnant. Dr. Tara Narula shares this sentiment: “The culture says don't talk about your pregnancy until the end of the first trimester, which means when you lose your baby, there's not that outpouring of community support to give us love and embrace us.” This cultural norm only further isolates a grieving mother who is left to untangle complicated emotions of lost motherhood and grief, not to mention significant hormonal shifts. The loss is experienced as an invisible loss.
What is an invisible loss?
An invisible loss is one that is unseen, unacknowledged, or unknown by others. It can feel as if the loss is invisible and unimportant. Without it being seen and validated by others, there is no process for dealing with complicated emotions. This lack of support during grief is something that can intensify feelings of sadness, anxiety, and a general feeling of being alone.
"As women, so much of our sense of self is tied into motherhood and fertility. And when we lose a child, the feeling is, I somehow lost it, I failed, there's something wrong with me or my body, and there's a tremendous amount of shame and guilt. And we tend to insulate and not share that…”, shared Dr. Tara Narula.
In any other type of loss, there is an opportunity to grieve publicly. There is usually a support system and a ritual or ceremony that creates a process for grief. Only in early pregnancy loss is there no such opportunity. The burden of grief is carried silently and in secret.
The grieving process and complicated grief
One of the most difficult things about grief and loss is that everyone has a unique experience. There is not one path of grief. We each arrive with our own history of experiences, thoughts, and emotions. We each grieve in a unique way. “Normal” grief refers to when a person goes through the common stages of denial, sadness, bargaining, anger, acceptance, and finding meaning. However if the grieving process is unsupported and there is no space to process the waves of emotions, a person can get stuck. Complicated grief often resembles ‘normal’ grief in the first few months, however it then lingers and remains unresolved. It often results when the grieving process has been complicated by other factors surrounding the loss.
No matter how common, a pregnancy loss is unique to each woman and brings with it a wave of emotions. It is often the loss of unmet dreams, hopes, and expectations. For others it might feel like a relief of an unwanted or unexpected pregnancy. It can bring up previous unresolved losses, previous miscarriages, and result in depression and anxiety. And amidst all of these emotions, it can remain invisible and result in complicated, unresolved grief.
Factors that often complicate the grieving of an early pregnancy loss:
Privacy and Control Some women choose to share their experiences, others keep it private. However, sometimes the control over whether or not to share a pregnancy loss is taken away. Depending on your own experience, you might have felt forced to acknowledge the pregnancy loss in a way that was uncomfortable and this can complicate your emotional grieving.
Previous losses If a woman has experienced difficulty getting pregnant due to fertility issues, has experienced trauma, or has had prior life or pregnancy losses, these events often compound the grief and experience of an individual loss. Grief is often layered and each loss brings up prior losses.
Lack of Services Offered for the Emotional Component of Pregnancy Loss Medical Professionals might overlook the emotional component of the miscarriage or chemical pregnancy. It is common to hear stories about women who have gone to the emergency room and unexpectedly discovered that they are having a miscarriage. The doctors and staff provide the necessary resources to provide care for the woman’s medical and physical complications, but often overlook the devastating impact of the emotional trauma and loss of pregnancy.
How can therapy help?
In my work with women who have experienced pregnancy loss, it has become clear that every loss brings with it a unique journey of experiences, thoughts, and emotions. There are common themes however, and the American Psychological Association offers a few areas to explore for pregnancy loss and how a therapist can help best support women who have experienced miscarriage and pregnancy loss:
By providing a space - for unmet hopes, complicated emotions, grieving the loss, and a space to explore how the loss impacts emotional wellbeing. In short, creating a space for your grief.
By rewriting the story - A therapist can help you to explore issues of identity and offer space to tell YOUR reproductive story of parenting and pregnancy journey. The image you held of pregnancy and parenting has been altered and it is important to be an advocate for yourself, to give voice to your story. There is strength in sharing your story.
By finding a sense of balance - Pregnancy loss often brings a cycle of feelings of sadness and anxiety, wondering what could have been different, and ruminating thoughts of asking why and what caused the miscarriage. Cognitive Behavioral Therapy (CBT) is a research proven method of therapy whereby a therapist helps you to cognitively restructure unhelpful thoughts such as failure, shame, guilt. Often women blame themselves and their bodies. They think, “I lost the baby, it is my fault, I am a failure.” However it is important to work to restructure these unhelpful self statements. A Licensed Professional Therapist can help you with this.
Why does it matter that the grief of pregnancy loss is processed?
When loss is not adequately given a space to be felt, acknowledged, experienced and supported, it can compromise emotional well being, impact body image and sense of self, complicate future losses, and alter attachment styles and bonding with other children and future pregnancies. Unresolved grief and anxiety resulting from pregnancy loss might also challenge personal relationships, confuse feelings about fertility, impact the experience of future pregnancies, increase the risk for perinatal anxiety and depression for future pregnancies, and leave a questioning of identity as a woman and a mother.
Early pregnancy loss can leave a woman feeling embarrassed, overwhelmed, and unsure of where to find help. It can be a lonely process, but it doesn’t have to be. By giving voice to pregnancy loss and expanding societal knowledge of factors impacting the way loss is experienced and supported, we can begin to provide a space for women to discuss all of the complicated emotions, to heal, and to feel more empowered and not so alone.
Ma Zen Space - Support for Women in Philadelphia and the Mainline
As a Licensed Professional Counselor and Registered Art Therapist, my work combines cognitive behavioral therapy, mindfulness, and art making to help provide a sacred holding space to bear witness to the grief, restructure unhelpful ways of thinking, and create rituals to help process the grief.
Reach out and find support for your journey today by emailing Megan Bousquet at info@mazenspace.com or visiting www.mazenspace.com to learn more.
