In this life, we all experience different types of loss. Grief is a normal response to all kinds of loss. Even so, it seems society gives us more space to grieve certain losses above others. When a close family member passes away, people expect you to take time for bereavement. Yet with pregnancy loss, expectations sometimes differ, even though it is still an intense loss of a close family member. 

Understanding Pregnancy Loss

Pregnancy loss, including both miscarriage and stillbirth, impacts many individuals and couples more profoundly than words can express.

Pregnancy loss can arise from various medical, genetic, or environmental factors. More often than not, it occurs without an identifiable explanation, leaving parents grappling with overwhelming emotions and unanswered questions.

Typically, loss occurs within the first 20 weeks of pregnancy, and this is known as a miscarriage. Any loss later than that is called a stillbirth. Regardless of the timing, the emotional aftermath can be intense, needing both empathetic care and informed support to navigate healing and recovery.

We acknowledge the depth of this grief. Though it may seem less tangible than other types of loss, as the parents had yet to “meet” their little one. It is no less real, this was their child, no matter the age. If you have experienced a pregnancy loss, you are not alone. You deserve a space to grieve, process, and heal.

Types of Pregnancy Loss

Miscarriage, the most common type, includes pregnancy loss before 20 weeks gestation and is most common in the first trimester. Often, women may miscarry before they even find out they are pregnant. Stillbirth is defined as the loss of a baby at or after 20 weeks gestation. Other types of pregnancy loss include molar pregnancies (atypical cell growth that do not result in a viable fetus) and ectopic pregnancies, when the embryo implants outside the uterus, cannot survive, and must be removed for the safety of the woman. Each pregnancy loss brings its unique set of challenges.

Miscarriage Information

Miscarriage, the most common form of pregnancy loss, affects many families each year. Although about 10-20% of known pregnancies end in miscarriage, the number is likely higher due to miscarriages that occur before a person even knows she is pregnant and unreported miscarriages. 

Causes of miscarriage can be multifaceted, and often cannot be clearly identified. Possible causes include genetic abnormalities, long-term health conditions, infections or immune system abnormalities, or abnormalities in the shape or function of the female organs. Miscarriages are most likely NOT caused by emotional stress, birth control pills accidentally taken in early pregnancy, or typical work environments, activities, reasonable amounts of exercise, or sexual intercourse. Miscarriage often happens during the first trimester, though it can occur at any point up to 20 weeks, emphasizing the importance of starting prenatal care as early as possible.

The main symptom of a miscarriage is vaginal bleeding or spotting, with or without abdominal pain or cramping, but sometimes there are no obvious signs. Lack or loss of pregnancy symptoms can also be a sign of miscarriage, but like pain and bleeding, that does not necessarily mean there is a problem.

A miscarriage can be diagnosed by a pelvic exam, ultrasound or blood test (which would show a drop in pregnancy hormone levels). Because continued blood loss can harm you, go immediately to your OBGYN or the emergency room of a nearby hospital to be evaluated.

Important: If this is your first pregnancy, contact your doctor to determine your Rh factor. The Rh-negative blood type can pose risks during pregnancy, including an increased risk of miscarriage or stillbirth in the second or third trimester. If you are Rhesus (Rh) negative, you will be given an injection of Rhogam which will prevent Rh problems in any future pregnancies.

If you are Rh-negative, most doctors will advise that you get a RhoGAM shot after you’ve experienced a miscarriage, ectopic pregnancy, or other pregnancy loss to protect future pregnancies.

In the wake of a miscarriage, acknowledging the loss and seeking support when you’re ready can help the emotional recovery journey. Support groups, counseling, or reaching out to your community can provide solace and understanding, empowering you to move forward with renewed hope and strength. The journey of healing, though challenging, will become more manageable with the right resources and a supportive network by one’s side.

Ectopic Pregnancy Information

When a mature egg is fertilized by sperm, it continues its journey down the fallopian tube toward the uterus where it will implant for the remainder of the pregnancy. The uterus is the only environment that a pregnancy can successfully develop and grow healthily. 

An ectopic pregnancy is one that is growing in the wrong place. While normally the baby grows inside the uterus, an ectopic pregnancy can implant in a fallopian tube (which is where the egg and sperm meet), an ovary, the cervix, or in the abdominal cavity (belly). Most commonly, it occurs in a fallopian tube. Ectopic pregnancy is rare, occurring in approximately 2% of all pregnancies.

An ectopic pregnancy cannot develop normally or be relocated to the uterus. The fertilized egg cannot survive, and the growing tissue can cause life-threatening bleeding if left untreated. 

Be aware that an ectopic pregnancy is considered a medical emergency and can be fatal. Pay attention to your body, especially before an intrauterine pregnancy is confirmed via an ultrasound. (Please note that it may take more than one ultrasound for an ectopic pregnancy to be diagnosed.)

At first, symptoms of ectopic pregnancy may seem like those of a typical pregnancy.  You may experience many of the same signs, such as a missed period, breast tenderness or upset stomach. As the ectopic pregnancy grows, more serious symptoms may appear such as:

• Severe pain usually located on one side of the abdomen or pelvis
• Lightheadedness, dizziness, or blackouts
• Bleeding from the vagina may or may not be present
• The passage of tissue (not just blood clots) from your vagina

If you suspect you may have an ectopic pregnancy, get medical treatment immediately from an emergency room or an OBGYN. Failure to get help may result in a ruptured internal organ and bleeding into your abdomen which puts you at a greater risk of death from shock (dangerously low blood pressure) or infection.

Stillbirth Information

Stillbirth occurs when a baby dies in the womb after 20 weeks of pregnancy, leaving a significant impact on the parents and extended families, who may require extensive support and understanding during this difficult time.

Causes of stillbirth can include placental problems, birth defects, infections, umbilical cord issues, or other pregnancy complications.

Addressing the emotional and psychological trauma of stillbirth demands a concerted effort from healthcare providers, counselors, and community support to offer a safe space for sharing and processing grief.

Navigating the aftermath of a stillbirth is a sensitive journey, requiring compassionate care and tailored support to help parents cope with their loss and find solace in ways that are most meaningful to them. It’s essential to understand that healing is a deeply individual process with no set timeline, and seeking professional guidance can be instrumental in processing grief and embarking on the path to recovery.

Supporting a Loved One Through Pregnancy Loss

If you know someone who has recently suffered a pregnancy loss, there are various ways to offer your support. 

Partner Support: As the partner, although you did not experience the miscarriage physically, it’s your loss too. You both get to play a pivotal role in providing solace for each other and fostering a pathway toward healing. A supportive partner can create a safe and comforting environment, allowing your loved one to express their emotions freely. Practice active listening and offer encouragement; be open about your emotions. Seeking joint counseling can also profoundly enhance mutual understanding and allow you to work through this loss together.

Family and Friends: It might be hard for your loved one to express their feelings in the moment, but assure them that you are there for them. Offer practical support, such as dropping off meals. Let them know you’re thinking of them with a card. Be patient but present, available when they are ready to share and let them know that they can talk about it with you. If and when they do share, listen to understand. It might not be the right moment to offer advice, but rather, grieve together with them and remind them of your love for them. 

Professional Support: It’s okay to seek professional help when you need it. If you have access to therapy or counseling, ask your provider to help you process your experience. If you don’t have access to mental health services, you can also seek faith-based support, such as meeting with your pastor or priest. Talk to your Clearway Advocate for names of mental health support resources near you.

Recognizing Grief in Pregnancy Loss

Grief doesn’t adhere to a singular timeline. As partners walk through this challenging journey, it can be hard for those experiencing pregnancy loss to find support as they grieve. 

Such grief is often met with silence or well-meaning but hurtful words. Although the nature of your loss is unique to you, you are not alone.

We believe parents and couples should have access to a space to safely heal from pregnancy loss experiences. Starting October 1, 2024, we will offer a Pregnancy Loss Grief Support Group the first Tuesday of every month. 

If you have lost a child, it is important for you to grieve that loss. This group is a place to talk about your grief in a supportive environment with others who are also grieving and to receive education and resources for your journey.

Pregnancy loss healing groups are open to singles and couples. If interested, contact clearpast@clearwayclinic.com to register or for more information.

Received by Amy G., L.I.C.S.W.

Resources:

N Engl J Med. 1988 Jul 28;319(4):189-94. doi: 10.1056/NEJM198807283190401.

Incidence of early loss of pregnancy A J Wilcox 1, C R Weinberg, J F O’Connor, D D Baird, J P Schlatterer, R E Canfield, E G Armstrong, B C Nisula https://pubmed.ncbi.nlm.nih.gov/3393170/

Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005 Oct 11;173(8):905-12. doi: 10.1503/cmaj.050222. PMID: 16217116; PMCID: PMC1247706. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247706/