Hidden Losses: Supporting a Friend After a Miscarriage (Part 1 of 2)

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miscarriage

Art Credit: Tina Sosna

For many women, pregnancy is a time of excitement and hope for the future—preparing birth announcements, decorating the nursery, and buying tiny socks and onesies. But when a mother unexpectedly miscarries, these feelings can quickly turn to grief and isolation. Suddenly, the nursery, once filled with happy anticipation, now seems an empty place of sadness.

One in four women experience a pregnancy loss, making it likely that we all know someone who had to come to terms with an unexpected loss. While you may want to help her, you may feel unsure of what to do or say and may even fear saying the wrong thing. But equipped with some expert advice, you can be prepared to compassionately support a friend while she grieves. In this two-part series, we will look at facts about miscarriage, the emotional impact on women, and suggestions for offering support when someone in your life has suffered a pregnancy loss.

So, what is a miscarriage?

The term pregnancy loss can refer to either a miscarriage (a spontaneous pregnancy loss before the 20th week) or a stillbirth (the death of the baby in the second half of the pregnancy or during childbirth). According to the American College of Obstetricians and Gynecologists (ACOG), miscarriages occur in about 15 to 20 percent of all known pregnancies, with approximately 600,000 miscarriages occurring annually in the United States. These statistics only apply to known pregnancies, but many women miscarry so early in their pregnancy that they are not even aware of it.

The causes of miscarriage remain elusive. According to one study, the cause of a miscarriage is identified in only 19 percent of all cases. The ACOG attributes about 60 percent of all miscarriages to an abnormal number of chromosomes in the embryo. The lack of conclusive evidence about their miscarriage can leave many women feeling a loss of control. In another study, 47 percent of women who miscarried felt guilty, and 40 percent said they felt that they may have done something to cause the miscarriage.

As a result, a friend who has miscarried may feel frustrated and betrayed by her body. Women often go over and over the events of the days leading up to the miscarriage in the hopes of finding a reason for the loss. You may find that your friend worries over the glass of wine she had before she found out she was pregnant or berates herself over lifting a heavy box. While it may not make sense to those around her, she is trying to find a reason for her loss.

It is also common for mothers to grieve not only for the loss of their child but also for the hopes and expectations that went with the thought of expanding their family. According to the latter study, 40 percent of women described feeling isolated by their loss—which may be amplified by hormonal changes—increasing feelings of sadness and anxiety.

Still,  65 percent of men and women believe that miscarriage is a rare event, estimating it occurs in only 6 percent of all pregnancies. One reason for the difference between the perceived and actual prevalence could be attributed to the “12-week rule.” Pregnancy books often encourage women to wait until they reach the 12-week mark in their pregnancy before telling family and friends the news. If a woman loses her baby during this time, she may choose not to tell her family and friends which could contribute to the perception that miscarriages happen infrequently. Still, 66 percent of the study participants believed that the emotional impact of miscarrying is severe.

Research has found that the intensity of grief a mother experiences is related to the strength of her attachment to the unborn child. Thanks to such technological advances as home-pregnancy tests, ultrasounds, and heartbeat monitors, it is now easier than ever for parents to form a bond with their unborn child early in the pregnancy. A friend who has miscarried, depending on how far along in the pregnancy she was, is likely to have ultrasound pictures of her baby, may have already chosen a name, and begun personalizing the nursery. All of these attachment-strengthening events can magnify the loss she is coping with.

The women in my life who have suffered miscarriages have each dealt with it differently. For many, a miscarriage can be a very traumatic loss, the emotional consequences of which should not be underestimated. One woman who lost her child before reaching 12 weeks waited to tell family and friends of her loss several months after and only once she felt emotionally ready. Another talks about her baby frequently to keep the memory of him alive. No matter how women choose to grieve, researchers have found that women grieve for longer periods of time than was previously thought. For some women, the grief never fully goes away. Remember: Grief does not have a deadline, and it is important to respect your friend's mourning process no matter how long it lasts.

Regardless of timing, a woman who has suffered a miscarriage needs time to grieve at her own pace with the support of her family and friends. Research has shown women benefit from spending time with other women in times of stress, making it crucial for family and friends to know how to offer effective emotional support. For this reason, researchers, psychologists, and medical professionals have stressed the importance for increased awareness of the high rates and emotional effects of pregnancy loss. The more awareness we have, the better we will be able to offer compassionate support to a friend who has suffered a pregnancy loss. Now more than ever, your friend needs to know that, despite suffering a loss difficult to comprehend unless you experience it yourself,  you are there to support her and that she is not alone.

Stay tuned for Part Two of this two-part series on how to support a friend who has experienced a miscarriage.