Miscarriage and stillbirth are emotionally intense and very unique forms of grief and trauma, ones that often occur in privacy and silence. For parents eagerly anticipating the arrival of a new family member, fetal death — whether it occurs early or late in pregnancy — can be devastating. The shroud of secrecy that hangs over these topics may make it challenging to talk about, but it’s critical to bring these conversations into the light.

I talked with two experts, Boston-based psychologist Aline Zoldbrod and Doctor Elizabeth Fitelson of Columbia University’s Department of Psychiatry, about the emotional and cultural issues surrounding miscarriage and stillbirth — and how to approach this very distinctive life experience.

Fitelson notes that advances in medicine have been a double-edged sword for new parents; neonatal mortality rates are dropping dramatically, and many people think of doctors as able to “fix” whatever crosses their path. The public perception of pregnancy, she says, has changed. It’s no longer a high risk life event for gestational parent and child, but a routine affair, with problems in pregnancy viewed as manageable.

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Grief Counseling OnlineYou don’t have to wait for help processing your loss. Access grief counseling within days

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You don’t have to wait for help processing your loss. Access grief counseling within days

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The truth is actually more complicated. More advanced medical care has made it easier to identify and treat problems in pregnancy. But some problems aren’t surmountable. “In a large percentage of pregnancies,” she says, “things simply don’t come together, and miscarriage is the expected outcome.” The silence about miscarriage statistics shapes the way we think about pregnancy and parenting, often to the detriment of expecting parents.

According to the March of Dimes, an organization devoted to neonatal welfare, around10-15 percentof pregnancies end in miscarriage, with pregnancy loss before 20 weeks gestation. The real number may be much higher, as some pregnancies quietly end before people are even aware they’re pregnant. While the relatively common nature of miscarriage doesn’t make it less tragic, it does highlight that this experience is not exceptional, and parents facing miscarriage are far from alone. Stillbirth, death after 20 weeks, is far less common, occurring in less than one percent of pregnancies — but given the number of pregnancies across the United States in any given year, that’s a tremendous number of people facing an intense emotional experience.

Why Miscarriage Is So Hard to Talk About

Given that miscarriage is relatively common, I asked Fitelson, why is it so hard to talk about?

“Because miscarriage isn’t talked about a lot, women’s expectations are that everything’s going to be fine,” she adds, highlighting the danger of viewing pregnancy as routine. Many of her patients don’t just experience grief. They also feel guilt and shame, wondering if they did something wrong or somehow caused the pregnancy loss. “It’s a very difficult feeling to have, when it’s completely not the truth.”

It’s hard for nongestational parents, too. While they don’t experience the physical and hormonal changes of pregnancy, and the sensation that another human being is growing inside them, they also form an attachment. Many nongestational parents are highly involved in pregnancies as active participants, but when it comes to pregnancy loss, friends and even family may not understand how emotional the experience can be. Fearing lack of compassion, people may grieve silently and in private.

Coping With the Emotional Aftermath of Miscarriage

“There are no rules,” Fitelson says, for grief and recovery from miscarriage and stillbirth. Every person responds to trauma in their own way and at their own pace. For friends and family members, respecting and validating that grief is very important. Acknowledging the grief and treating miscarriage and stillbirth as real losses create a safe space for people to talk about their experience.

“The most important thing for women who miscarried,” says Zoldbrod, “is to join a miscarriage support group. In a miscarriage support group, people understand your pain. Another really terrible thing about miscarriage — or being infertile — is the unbelievable envy one feels when one sees pregnant women…in a miscarriage support group, no one will tell you you’re going to hell for having those feelings.”

Sometimes, support of friends and family isn’t enough. There’s cause to worry when grief starts to interfere with people’s lives, and when they have trouble going about their day. If someone appears to be suicidal, or is contemplating self-harm, it’s especially critical to get outside help. But therapy can be helpful even when people aren’t feeling like their grief is out of control — talking to a professional in a safe setting can help people unpack and process grief, with or without a partner. And it’s not about “getting over it,” but moving forward.

Miscarriage doesn’t have to be the subject of silent stigma and shame, but that’s a process that begins one person at a time. Being frank about pregnancy loss can reduce the sense of feeling alone, while affirming the validity of grief can help parents feel more comfortable grieving with their community, rather than doing so in isolation.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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