How we talk about pregnancy leaves women and their families alone with the experience of miscarriage
A miscarriage is a complicated loss that is very often silenced by how we talk—or don’t talk—about pregnancy. There is a collective rule to not share pregnancy news until after about twelve weeks when the risk of a miscarriage is lower (a miscarriage is a pregnancy loss before twenty weeks). While this rule likely exists to not get others’ hopes up and shield women from having to do the painful work of sharing disappointing, painful news after excitement, it can be unintentionally unhelpful. In fact, it often forces women to have to disclose for the first time that they were pregnant at all before also talking about a miscarriage.
This can feel insurmountable and, as I recently explored in a segment, “Making Space to Talk about Miscarriages,” on NECN Boston, leaves women and their families alone to deal with a miscarriage. The truth is you need people around you when losses happen. Yet, the ways we isolate miscarriage frequently drive women, their partners, and families to keep it to themselves. The loss, then, gets buried and, at worst, becomes a secret that is never worked through.
We only want to deal with joy-filled pregnancy: This splits off miscarriage
As a culture, we only want to deal with successful, joy-filled, happy pregnancies. However, that is not always the way it goes. Miscarriage is a common loss (about 1 in 5 pregnancies end in miscarriage) and yet it’s split off from how we normally discuss pregnancy. Miscarriage is rarely talked about in sex ed. There aren’t commercials or products related to it as there are for other baby-related experiences. For an individual or family in mourning, there aren’t the same rituals around grieving a miscarriage like a funeral or other gatherings.
In some ways, this isn’t surprising. Our culture wants losses to be quickly understood, dealt with, and cleaned up. A miscarriage, though, is complex and messy—this rapid grieving process, in which you feel sad for a bit before going back to life as is, comes up short. A miscarriage represents a loss of a hope, a dream, a plan, and a want for a family to grow. It’s also losing a baby, sometimes in ways that can be medically complicated. Because of this, it can feel easier to avoid talking about the experience. While this might seem tidier, it leaves women, couples, and families isolated to suffer the miscarriage loss by themselves, unable to fully feel and grieve the experience with community support.
Silencing a loss like miscarriage makes it harder to work through
When you don’t acknowledge a loss or brush it off as “not a big deal” in an attempt to deny how you really feel or make it easier for others, that loss can become crystalized in your system. It can haunt you while you ignore its impact or avoid getting close to it at all costs. The loss, then, becomes harder and harder to work through.
In my practice, I see how a miscarriage can affect the fabric of the relationship individuals have with themselves, as well as relationships with partners and family members as they move forward. Even if a woman or couple works hard to avoid the messy feelings, those feelings remain and come up in both expected and unexpected ways. For instance, some individuals become anxious about their next pregnancy or rush to be pregnant again in an attempt to avoid thinking about the miscarriage. Others drift apart from pregnant friends and family, pretending they’re okay while feeling isolated and hurt. A miscarriage impacts a couple too, whether partners feel nervous about trying again, brush past the topic when they do get pregnant, or avoid the elephant in the room during sex.
There is also an added challenge for those who have had multiple miscarriages. These multiple experiences become complex grief—not just grieving the loss of one child but many hoped-for children. It can seem like a merry-go-round of emotions that are almost too scary to ever hope for a good outcome. Medically challenging miscarriages too can be a double loss: the loss of the pregnancy and the loss of mercy in that moment, which often feels impossible to share the reality of the bleeding, the faintness, and the feeling like crap.
How do we disrupt the silence around miscarriage?: Talk about it
If more people talk about pregnancy in a way that includes the reality of miscarriage, we can disrupt the silence around these losses and learn to make better sense of them. When an individual allows themselves to openly discuss a miscarriage, they socialize the grieving process and create support around what they may need now and in the future. Granted, it’s understandable to not want to talk about a miscarriage until you feel ready. The feelings, however, will come up at some point and it’s important to have people around you who can receive this loss.
Part of the solution is talking about pregnancy earlier, which encourages a joining of friends, family members, and even coworkers to acknowledge that this is happening. You’re essentially saying, “I’m pregnant and I know there could be a loss, but I’m open to bearing the loss despite that.” This normalizes the complicated experience of miscarriage, including the sadness, disappointment, pain, and eventual acceptance.
Therapy can help explore what a pregnancy and miscarriage meant, as well as make meaning from loss
Therapy, in particular, is a place where women, couples, and families can talk about miscarriage and come to understand the meaning of the loss for them at a certain moment in time. In my practice, I approach the experience with curiosity in order to discover what the pregnancy meant to the patient and their family—what the journey was, how they came to be pregnant, and what the baby—this baby—meant to them.
I also help individuals and couples work through the complexity of their grief. With a miscarriage, there is a lot to unpack that sometimes bumps up against other unprocessed losses. There is a usefulness to understanding what the loss feels like at that moment and how to integrate it, including through doing a ritual to honor the loss and embrace the pain and messiness. This ritual might be a walk with a partner where you talk about the loss you’re both facing, organizing a talk and a moment of silence with family, or writing a letter to this baby that you lost to connect with its meaning, your hope, and your partner’s hope. Because we don’t have a standard ritual around grief for miscarriage, there is an opportunity to make one up and invite others along. By fully feeling and understanding the loss, you can, then, choose how you want to move forward if and when you want to try again rather than just avoiding the messy feelings altogether.