According to the March of Dimes, “It takes weeks to a month or more for a woman to recover physically [from a miscarriage], depending upon how long she was pregnant. [But] it often takes much longer to recover emotionally.  Women and their partners may experience intense grief as they mourn their loss. Emotions often include numbness, sadness, guilt, difficulties concentrating, depression and anger. A woman and her partner may handle their grief in different ways, creating tension between them at a time when they need each other the most.”(3)

On top of this, studies have found that women often blame themselves for the failed pregnancy in the immediate months after it occurs.(4) But according to the American College of Obstetricians and Gynecologists (ACOG), more than half of all miscarriages in the first 13 weeks of pregnancy are caused by problems with fetal chromosomes or genes. To explain this further, ACOG says: “Extra or missing chromosomes or genes mean the fetus will not grow as it should. Often, miscarriage is nature’s way of ending a pregnancy in which the fetus would not have been able to live. Many such problems occur by chance and have nothing to do with the health of the mother or father.”(5) In other words, in the vast majority of cases, there’s nothing the parents can do to prevent a miscarriage.

Still, out of 1 million miscarriages, approximately 15% of women suffer clinical depression and 45% experience increased anxiety.(4) Concerns, in the form of questions, include:  Why did the pregnancy fail?  Is it likely to happen again?  How long will I grieve? Are my feelings, and those of my partner, normal?  If not, how do I get help in recovery?  To answer these questions, ACOG advises follow-up visits with a doctor and, at times, referral to a counselor.

In many cases, the grief dissipates within four months, and acceptance soon follows. But it’s important for patients to take as much time as they need to heal emotionally — even though a woman’s body may be ready to conceive again in just a month or two. (3)

If there is any good news here, it’s that 85% of those who suffer a failed pregnancy will later have a successful pregnancy and the birth of a healthy child.6 For the small percentage of couples who experience two, three or more miscarriages in a row, a complete medical evaluation should be performed to try to determine the cause. Couples should note, however, that research in this area is very new. Testing only reveals the cause of repeat miscarriages half of the time. For many, the exact reason may never be known.(1)

Many emotions are triggered when a baby is lost through miscarriage, and a culture of silence and misunderstanding can sometimes surround such an event.  Family and friends should educate and prepare themselves. Sometimes it’s hard to know what to say or what to do. Here’s some good advice from the March of Dimes: “While it is very difficult to find the words that might help the grieving family, it is comforting to tell them ‘I’m so sorry for your loss’ or to admit ‘I don’t know what to say.’  Letting a family know ‘I’m here for you’ or ‘I’m praying for you’ is also a help.  Even tears are comforting.  Do not make comments like ‘you’ll get over it in time’ or ‘you can always have another baby.’  The parents need to grieve this loss.  Try to be sensitive to their deep loss and the fact that, while time may ease the grief, they will never get over it.”(3)

So be available, and be ready to listen.  Help with errands and meals.  Acknowledge the baby existed and share the grief.  If parents wish, tell others for them.  And be aware that certain times – such as the baby’s due date or pregnancy loss date, will be sensitive times, marked by sadness and extra need for kindness and support.  Finally, if depression or anxiety visibly persists beyond several months, encourage additional counseling and support.

Around one million American women and their partners suffer a lost pregnancy each year. It’s
regrettable that most cases are not preventable. But it’s unconscionable to allow these parents to suffer in isolation and silence, and without adequate support.

For HealthCommentary, I’m Mike Magee.

References

1. Daly E. Specialists Trying to Unravel the Mystery of Miscarriage. The New York Times.
February 8, 2005.
2. American Pregnancy Association. “Miscarriage.” Available at:
http://www.americanpregnancy.org/pregnancycomplications/miscarriage.html.
3. March of Dimes. “Miscarriage.” Available at:
http://www.marchofdimes.com/professionals/14332_1192.asp.
4. Nikcevic AV, Tunkel SA, Kuczmierczyk AR, Kypris NH. Investigation of the cause of
miscarriage and its influence on women’s psychological distress. British Journal of Obstetrics
and Gynaecology. 1999;106:808-813.
5. The American College of Obstetricians and Gynecologists. “Repeated Miscarriage” patient
education pamphlet. Available at:
http://www.acog.org/publications/patient_education/bp100.cfm.
6. iVillage. Pregnancy & Parenting. “Miscarriage: Answers to your 10 most-asked questions.”
Available at: http://parenting.ivillage.com/pregnancy/pmiscarriage/0,,n2vm,00.html.