Coping With a Pregnancy Loss

Miscarriage is common in early pregnancy, occurring in 10% to 40% of all pregnancies. And recurrent pregnancy loss (RPL)—the spontaneous loss of two or more pregnancies—is also more common than many people realize, affecting as many as 5% of couples.

In recent years, there has been more public awareness about women’s experiences with these problems, but even so, they’re often “silent losses,” especially if they happen early in the pregnancy. Most other kinds of losses and deaths are publicly acknowledged in our society. But with these silent losses, women often don’t feel that they have the right to grieve. And they often feel alone in their grief.

Below, three experts at Lucile Packard Children’s Hospital Stanford and Stanford Hospital who are working to break the silence that still surrounds this topic offer their collective coping strategies, advice, and insight for women who’ve had a loss. Dr. Ruth Lathi is the director of the Recurrent Pregnancy Loss Program, which is part of the broader Stanford Medicine Fertility and Reproductive Health Program and helps patients who have had unexplained pregnancy loss successfully build a family. Dr. Ellie Williams is the head of the Stanford Women’s Wellness Clinic and clinical professor in the Department of Psychiatry and Behavioral Sciences, which has provided specialized mental health care to women for more than 20 years. Jane Zimmerman, a social worker in the Family Guidance and Bereavement Program, sees Stanford Medicine Children’s Health patients one-on-one who have lost a pregnancy or a baby.

Acknowledge the loss. Physically, it takes one to two months to recover from a pregnancy loss, but emotionally the average is three to six months. Many women think they should go right back to work or pretend that what they’re going through isn’t painful. But grief is an expected response to a loss, and it’s truly traumatic to lose a pregnancy. When you lose an older child, you lose a whole past. But with an unborn baby, you lose a whole future, and it’s normal to feel cheated and bereft. Try to honor what happened and remember that this level of pain won’t last forever.

Know that it’s not your fault. It’s common for women to blame themselves for the loss and shame themselves with thoughts such as “Why can’t my body work as well as other women’s?” Most miscarriages are due to a combination of genetic and developmental abnormalities with the fetus or baby, and recurrent pregnancy loss can be due to a combination of many genetic and environmental factors. Watch out for shame and self-blame—they are not good friends to you, and they’re not warranted.

Open up. Don’t go through it alone. It’s important to talk to your partner, family, or friends when you are ready. Find someone who is a sympathetic listener, who understands how hard it is and how much it hurts. It’s important to express what your wish had been for your child. People begin to get over grief when they can say what they wish had happened, how sad they are that it didn’t, and what they wish for the future.

Take the time for self-care. Pay attention to how you talk to yourself and how you physically treat yourself. When you’re able to, try to exercise and do a meditation or relaxation practice. They are crucial for regulating your mood and anxiety. Where people get in trouble is beating themselves up for the loss. Beware of that tendency, and when you find yourself having these thoughts, say to yourself: Stop—what’s another way to look at this? Brief cognitive behavioral therapy can help.

Fake it till you make it. During this time, some women can’t imagine finding joy in things again. With what’s called behavioral activation, you can identify specific pleasurable activities that you did before the loss and do them again, even if you don’t feel like it. For example, if you used to like walking in nature, go out and do it. This can help your mood, especially when you’re feeling anxious or depressed.

Know when to get help. Don’t be afraid or embarrassed to ask for help from a psychiatrist or to join a support group. Signs that you should get help are if you’re utterly preoccupied with the loss, are unable to enjoy things, or have suicidal thoughts. Be honest with yourself if you’re having symptoms of posttraumatic stress disorder (PTSD), depression, or anxiety. Also get help if nightmares about the loss go on and on, you can’t sleep, you’re constantly on edge, or you become very withdrawn.

Our hospital offers support, and you can also find a therapist in your community who is experienced to help with this kind of trauma. For families experiencing a loss, we often recommend HAND, which has a unique pregnancy loss program in the Bay Area.

Resources

Packard Children’s Hospital Family Guidance and Bereavement Program: (650) 497-8175

Help After Neonatal Death (HAND): handsupport.org