A Lonely Event
Pregnancy loss is a unique and often lonely event in a woman's life that can trigger profound grief. Healing is helped through understanding and dealing with any physical and emotional changes. Pregnancy loss can occur in several different ways. It may be a miscarriage (if the pregnancy is less than 20 weeks); a still birth (if the pregnancy is more than 20 weeks); a recurrent pregnancy loss; a neonatal death or a termination (either early or late).
Physical recovery occurs quite quickly while emotional response and recovery can be more varied. Some women experience little or no emotional disturbance while others experience feelings of sadness, depression, anger, guilt or self-blame. The grief symptoms usually decrease in intensity over the first 12 months and will gradually resolve with time.
Women may not always have support from family and friends or it may not be enough. There may be skilled people or a support group in your community; ask your doctor or community health nurse. ln hospital, there will be contact with nurses, possibly a hospital social worker or a Spiritual Carer who can help. After you go home, you will receive a telephone call to see how you are coping.
How some women feel
Women may experience many feelings at this time which may include numbness, shock, confusion, exhaustion, disbelief, anger, fear, isolation, loneliness, pining, yearning, self-blame or guilt feelings, sadness, and even depression. The intensity of these feelings can range from mild to quite overwhelming. Recent studies show there is often no order or sequence to grief and that different feelings surface at different times throughout the grieving period.
As all losses are not the same, neither are all reactions to grief. Women may have other losses or needs occurring in her life at the same time and she may require support and information. Future family planning decisions may be difficult at this time and may be best left for when grief is less intense. Women should be encouraged to take time out and make arrangements for private time and rest.
Partners also suffer and can experience many emotions and feelings at the loss of a pregnancy. They can feel isolated and helpless when the focus of attention is with the hospitalized woman experiencing the physical loss. Partners are often expected to remain strong to provide support and their own feelings of sadness and loss may be hidden in the process. It is important that each partner is given the opportunity to express their loss without blame.
Couples experiencing grief over a pregnancy loss often discover that their responses are different from one another. This is normal but it can place a strain on a relationship if not recognized. Talking about differences can be helpful.
Partners may also play an important role in talking to other family members (including children) about what has happened and what will happen in the immediate future. It is helpful to discuss together how to handle questions from children, family and friends before speaking with them.
Children are unprepared for loss. They need both patience and support in helping them to understand. How much a child can understand depends on their developmental readiness. Generally children deal best with loss if they are given information that is appropriate for their age. There are booklets especially prepared for children. A social worker may be available to help you prepare your other children for this loss.
The Reproductive Mental Health Program assesses women who have experienced pregnancy loss and developed complicated grief reactions or grief that has developed into a Major Depressive Disorder or an Anxiety Disorder, including Post Traumatic Stress Disorder (PTSD). Treatment options may include short term Grief Counselling with a Nurse Clinician or Clinical Counsellor. Medication treatment for patients with more severe illnesses may be offered.