Trigger Warning
This post contains information and medical descriptions of miscarriage, therapeutic/medical abortions, stillbirth and pregnancy loss.
“You never arrived in my arms, but you will never leave my heart.” — Zoe Clark-Coates
Pregnancy Loss is a complicated and previous taboo subject that many women and families have been through in their family building journey. I have had a pregnancy loss and it was one of the single hardest days of my life. Remember that you do not need to be ashamed of this – no matter how your loss took place. You deserve to talk about it and process your feelings in order to heal. You are still a woman or family with dreams, even if after the loss your dreams change. You do not need to do this alone.
Types of Loss
Miscarriage
Miscarriage is unfortunately a very common occurrence to expecting families. They occur in approximately 15-20% of all pregnancies. There are a few different types of miscarriages and it is vital to include them all – as they all may be grieved by those who experience them.
A miscarriage is defined as a loss during pregnancy before 20 weeks gestation.
A threatened miscarriage is when you show symptoms of a miscarriage such as vaginal bleeding or cramping, but the cervix remains closed. Some threatened miscarriages go on to have viable pregnancies, but some are lost.
A complete miscarriage is when all of the pregnancy tissue has left your uterus.
An incomplete miscarriage is when some of the pregnancy tissue remains in the uterus. Medical intervention is required to remove the rest of the pregnancy tissue.
A missed miscarriage occurs when the fetus has died but the pregnancy tissue remains in the uterus. Sometimes this is only identified at a routine ultrasound appointment. Your medical provider would provide you with options on how to deal with your particular situation.
Therapeutic Abortions
Therapeutic aboprtions (TAs) are certainly a highly charged topic as of late, especially in the USA. They are defined as a deliberate termination of the pregnancy. This may happen for a variety of reasons including an unwanted pregnancy, the fetus may have abnormalities incompatible with life or the mother’s life may be at risk. This is not an inclusive list of reasons. The most important thing to remember with any therapeutic abortion is that the mother or family may still grieve the loss of the pregnancy.
Stillbirth
A stillborn baby is defined as a fetal demise after 20 weeks gestation, or weighs more than 500 grams at birth. The baby is born with no signs of life. This may happen in the 2nd or 3rd trimester of pregnancy, and the cause is usually unknown. In Canada, the rate of stillbirths is 0.85% of all births for 2020, and in the United States it is 1 in 160 births.
Investigations After Loss
After the loss of any baby or pregnancy there may be a request by the healthcare provider or the mother or family to investigate the cause of the loss if it was unexpected. This may or may not be possible in all miscarriages depending on the gestation and if any fetal tissue is able to be saved for testing.
Included in the list of interventions that should be provided to all families grieving a pregnancy loss is attention to the needs of the parent(s) emotionally and discussion of future family planning.
Stages of Grief
Kübler-Ross proposed that there were five stages of grief.
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
You may feel all of these stages separately, or together. You may experience them for a few minutes, or days or weeks. You can also move forwards or backwards. There is no expected timeline for any family to recover. This journey is experienced differently in all individuals.
Healing
Approximately 1 in 5 parents will suffer more intensely from the grieving process and be diagnosed with adjustment disorders, such as depression, post-traumatic stress, or complicated bereavement.
If you ever feel unable to cope with the grief of your loss, it is essential you speak to your primary care provider for a medical assessment and plan for help. We know that women and families who are able to receive compassionate care from their healthcare providers and sensitive and caring, positive support from the families – are able to heal. They are able to feel that the loss has been validated and grief is acknowledged.
Counseling may be particularly beneficial for those families who are struggling to process the loss of the pregnancy. This may come from a counselor who specializes in the perinatal period.
Peer support groups are readily available and provide opportunities to sympathize with others who have faced similar situations and can make you feel like you’re in a community.
If you are looking for support in Canada – check out PAIL (Pregnancy and Infant Loss Network) to find peer support. You can also find more support groups at Bereaved Families of Ontario (BFO).
If you are looking for support in the United States, check out Postpartum Support International.
Honoring the loss of the child may be important to some families. This may look like holding a memorial service, joining a memorial group, taking the time to remember the date with friends or family or keeping something that reminds you of the pregnancy or child. Remembering this pregnancy or baby is a normal, healthy part of loss.
Family planning can be an essential part of the healing process for some families. Many women and families are able to go on and have a child after the loss in pregnancy. This idea may be scary at first, which is why discussing your wishes with your partner, your family, and your primary care provider can be so valuable in determining your wants and needs related to this complicated process. It is okay and normal to grieve your pregnancy or loss and want to try again. It is also okay if you need to take a break, or think you need to think about your life plan and if it still includes having more children.
Lastly, the best natural way to take care of yourself during this loss is to do the basics. Try to eat well balanced meals, drink plenty of water and sleep. Getting at least 30 minutes of daily exercise and having social interaction with close friends or family can also really help our mental and physical health. These basic human needs are essential tools we can use to be able to process our grief. Taking time away from social media, watching TV, isolating, and eating processed foods have all been known to make us feel worse. Use these in moderation only.
If you or someone you love is struggling with loss of a pregnancy, The Mama Coach can still help. We provide postpartum and prenatal support and may help find resources or refer you to other specialists to help you in your healing journey. You do not have to do this alone – a pregnancy loss is not something to be ashamed of. You deserve to heal, and have your feelings validated in a way that is meaningful or helpful to you. For more information on our postpartum support packages click here.
