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In September of 2015, we found out I was pregnant with our third child. I have a history of high-risk pregnancies (both my daughters were born premature), so I require more frequent ultrasounds than normal. At our six-week appointment, the heartbeat was like a thundering herd of horses; little arms and legs wiggled. I was smitten.

I ate healthily, did light exercise, and was extra-careful. I’d tell stories and sing lullabies. Soon, our girls gave my growing tummy a name: “Baby Belly.” At week nine, there were tiny fingers and toes. At week ten, the strong outline of a spine. At week eleven, though, the screen was black and blue, not the fiery red indicating the heat of another human being.

Our doctors found no heartbeat. We were devastated.

Every miscarriage statistic, pregnancy, loss, treatment, period of mourning, and healing is different. But going through this myself, I’ve noticed many common qualities among women who’ve miscarried. Because every experience is unique, please consider the following as a broad overview to help equip you or a loved one if you’re ever faced with a similar situation.

It’s So Common, But Few Talk About It

I blame the pervading silence on the myths surrounding miscarriage. In a recent survey, LiveScience reports that 55 percent of Americans believe miscarriage only happens in 5 percent or less of all pregnancies. Yet, the American Council of Obstetricians and Gynecologists notes that “anywhere from 10 to 25 percent of all clinically recognized pregnancies will end in miscarriage.” Further, many women will experience an early miscarriage and never even know it, as bleeding will occur around the same time of her expected period.

Part of the reason why miscarriage seems to be clouded in mystery and awkwardness may be because we misunderstand the causes. LiveScience reports that 76 percent of survey respondents falsely attributed miscarriage to something the mother did: a stressful event, lifestyle choices (e.g., drug or alcohol abuse), lifting a heavy object, IUD use, oral contraceptives, or getting into an argument. Some of these may increase the risk—and, in any case, it’s best to avoid them—but these alone do not cause miscarriage, researchers say. My mother remarked that perhaps I hadn’t been eating enough. My grandmother blamed it on me carrying my daughters. Their misconceptions made me angry at them and at myself. I couldn’t help but think, “What if it was my fault?” I felt frustrated and betrayed by my body.

Julia Hogan, LPC, writes, “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.” But the ACOG notes that the vast majority of miscarriages occur because of fetal chromosomal abnormality, improper implantation, or advanced maternal age and fertility health.

A First-Trimester Miscarriage Isn’t Always ‘Like a Heavy Period’

About 50 percent of women will miscarry naturally with the most common symptoms including “vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina,” according to MedlinePlus. But what about the other 50 percent of miscarriages?

At least three women I’ve spoken with, including Verily’s art director, Katherine Torres, nearly bled to death. Torres told me, “It turns out that if you have heavier bleeding, i.e., more than one pad an hour (at one point I had soaked through twenty-six in one hour), you should go to the hospital. You can go from fine to not in a matter of less than two hours.”

Some women may have to take medication to expel the tissue. Others may require a surgical procedure called dilation and curettage. We waited two weeks for my body to deliver the remains, but it still thought I was pregnant. So, our doctor ordered a D&C to prevent infection and further complications.

It’s Physically and Mentally Taxing

Common miscarriage side effects range from mild to severe. Some women experience labor pains and contractions. I also experienced other common side effects including vomiting, cramping, fatigue, and heavy and irregular bleeding for a month after the D&C. It took six weeks after we found out about the miscarriage for my hormones to balance out and for me to no longer feel pregnant. It’s shocking, as neither the ACOG nor the U.S. Library of Medicine mention the difficulty of the hormonal shift in their overviews of miscarriage. Yet many women find it to be the hardest part of the process.

One woman who has had two miscarriages writes to her sister, “Your body has been playing a cruel trick on you.” Severely nauseated and with tender breasts, our girls would pat my swollen tummy, saying, “It’s the Baby Belly, Mommy!” But with no baby inside, it was a bitter ruse.

Learning to accept the physical changes and emotions as they came helped me endure it. On Thanksgiving, I needed a seat on a crowded train. I felt so sick, and it was a two-hour ride. So I asked a young man near me, “May I sit? I’m pregnant.” (Hormonally, I was.) If I needed to sleep, I slept. If I needed to cry, I cried. I avoided places with pregnant women and young children. I spent a lot of time praying and “talking” to the baby, which may sound crazy, but it affirmed my feelings of sadness and loss. It brought me peace. He may not have been real to anyone else, but he was real to me.

Already Having Kids or Getting Pregnant Again Doesn’t Make It Easier

After we found out, my husband and I walked to the cathedral where we were married, a few blocks from our doctor’s office. I sobbed through the service, “I wanted this one. I wanted this one.” As I write this, I would have been more than seven months pregnant. I still have feelings of wanting this baby whom I will never get to hold. It sounds selfish; I have two healthy girls, after all. But from the moment I saw those two lines on the test strip, I had great hopes for who this specific person would become. Would he be tall like his father and mischievous like his sisters? I dream of him still. In my guilt, I wonder, should I have hoped at all?

Hogan notes, “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.”

It’s Isolating and Can Feel Shameful

Whether a woman has a great support network or not, the hidden nature of miscarriage loss isolates her. At the time, I didn’t know anyone who had miscarried. Discussing something so personal and painful with strangers was the last thing I wanted to do. My own husband couldn’t grasp how I felt. “It’s more real for you than for me. It didn’t happen in my body,” he said. My therapist’s first (and only) response felt dismissive: “It’s so common. There’s nothing you can do about it. You just have to move on.”

My emotions and my body were a mess. We had a cremation, a memorial, jobs, a home, and two young children to take care of, but no one offered to lend a hand the way one might have if we’d lost an older child. I searched for local miscarriage support groups, but the closest one was too far to commute with two toddlers. I hungered for someone to walk with me in my sadness, even if it meant a simple text asking, “How are you today?” I wish I was strong enough to reach out to family and friends for help, but I felt too depressed, guilty, and, yes, ashamed.

Research has shown that “women who miscarried were found to be at an increased risk for experiencing anxiety symptoms” and depression up to three years after the pregnancy loss. Here are ways you can support a friend through and after her hidden loss, including how comments we intend to be hopeful can come across as diminishing and hurtful. The smallest gesture can make a big difference. A couple of friends sent us cards and books on how to cope, which I reread often. I keep them at my bedside because they continue to bring us healing and comfort.

It’s Not You, It’s Me

Molly Walter, a multiple miscarriage survivor, shares, “Sometimes it’s me, not you. I’m happy for my pregnant friends and friends with little babies, but sometimes I need to step back and let myself process. I’m still supportive and in love with your child, but I need time and space.” My sister gave birth one week after my D&C, and I have five pregnant friends who share due dates within a week or two of the one I had. Seeing and hearing their updates brings me joy and relief in their healthy pregnancies, but they’re also a painful reminder of what could have been. Walter adds, “The grieving process doesn’t begin and end at the loss. I never felt like I could really begin the healing process until my due date had passed.”

Grief has no timeline. As my friend and Verily contributor Lindsay Schlegel writes, “So many women I’ve met have had the false impression that their feelings of grief post-miscarriage were over the top or too serious for such a loss. They felt that they were not supposed to be as sad as they were. And yet, I think most people would agree that the pain of a parent losing a child is great suffering. Why should it be any different when we didn’t get to meet our children face-to-face or watch them draw a breath?”

A community generally rejoices at the announcement of a pregnancy or birth. Let us remember that it also takes a village to support a mother and father when they lose a child, thundering heartbeat or not.

Photo Credit: M Sundstrom