Pregnancy should be a time of joyful anticipation, awaiting a little bundle of joy at the end of a long nine months. Sadly, all too often pregnancy ends not with the joy of a newborn child, but with the sorrow of miscarriage.
The medical term ‘spontaneous abortion’ is used when the uterus expels the products of conception before the 20th week of pregnancy. In simple terms, a miscarriage is the unplanned end of pregnancy, a very common occurrence resulting in the loss of approximately 25% of all pregnancies, 75% during the first trimester.
Having suffered two miscarriages before the birth of my son, I recognize too well the profound sense of loss, guilt, grief and devastation that follow miscarriage. Parents often feel an overwhelming lack of support and understanding following their loss and are left with many unanswered questions. There are many suggested causes for miscarriage such as infection, hormone imbalance, and chromosomal disorders. According to Dr. D. Shuwarder MD, about 50% of miscarriages are due to some genetic abnormality which causes the body to dismiss the embryo. The cause of the remainder remains unexplained. Second trimester losses are much less common and are usually thought to result from abnormalities of the uterus or placenta, maternal diseases and conditions that affect blood supply to the fetus.
The emotional and mental impact of miscarriage is huge and many mothers feel that there is an overall failure to recognize the true feelings of bereaved parents following miscarriage. Parents want to know why their baby failed to develop but very often no medical reason can be established, leaving mental anguish and uncertainty about future pregnancy. Sometimes a ‘missed miscarriage’ occurs and the mother has the emotional distress of knowing that the baby she is carrying had died and may have to undergo a dilation and curettage, or D&C, a surgical procedure performed to remove tissue from the uterus. Following this loss, there is a physical recovery to deal with, coupled with the body and hormones adjusting to not being pregnant.
Women may experience loss of appetite, problems with sleep, loss of energy and lack of motivation. There is a real need to acknowledge that sadness, depression and a true sense of loss are normal reactions to miscarriage. Parents begin fantasizing about their unborn child early on but following miscarriage, parents have no concrete memories of their child to hold on to, sometimes only an ultrasound picture to remind them of their child. One mother described feeling ‘in limbo, — I felt as if I was grieving not only for the lost child but for some part of me that had died as well’. (Vonney). Another mother described the ‘emotional umbilical cord formed between the baby and my soul at the same time as the physical one – my body healed more quickly than my soul’ (Alexandra).
Society doesn’t always recognize miscarriage as the death of a child or the subsequent need for grieving. Bowlby (1980), when talking about the loss of a child, stated that parents should be able to see a child after death, to hold him, give him a funeral and a grave. Without such provision, parents are faced with a ‘non-event and no-one to mourn’. The healing process for these parents is therefore very difficult and an element to coping may be to give the unborn baby an identity, to talk about the baby or even have a farewell ceremony.
For most women, miscarriage is a chance occurrence, however you need time to get over your grief before being emotionally equipped to attempt another pregnancy. For women who suffer repeated miscarriages, pregnancy usually means cautious hope accompanied by fear of another loss. It is vital to consult health care professionals who may offer investigations prior to pregnancy as well as guidelines for pregnancy management and regular monitoring. Professionals need to be aware of the importance of counceling following miscarriage, which can include the possible underlying causes if miscarriage and can give a mother the chance to express fears and feeling of sadness or depression and help towards resolving these feelings.
The loss felt following miscarriage may take a long time to feel less painful and the memory of your baby may never go away. However, talking to the others who have suffered similar losses and seeking out support groups can be a big help. Eventually Life does return to normal, and with it the possibility of future pregnancy and all the joy that a baby brings.v