Finding Hope After Loss: Coping With Pregnancy Loss
Watch Dr. Sharp's Presentation
Women and their partners who experience the loss of a pregnancy – be it a miscarriage, stillbirth or death of a baby shortly after birth – are often starving for emotional support. Unlike more expected losses, such as that of a very sick grandparent, the loss of a pregnancy is still viewed by many as a taboo subject. Unfortunately, this only intensifies the sense of isolation and emotional pain for women and their partners at a time of great vulnerability.
“Women who lose a pregnancy often find that even their best friends or closest relatives may become more distant,” says Kristen Sharp, MD, a UW Health obstetrician-gynecologist who leads the UW Health Hope After Loss Clinic in Madison. “People often worry too much about not knowing what to say, instead of just being there.”
Moreover, says Dr. Sharp, there is a public misconception about the prevalence of miscarriages.
“Research shows that 15 to 25 percent of clinically diagnosed pregnancies end in miscarriage, although surveys indicate that the public believes it is only about 5 percent,” says Dr. Sharp. “While understandable, since many women never announced their pregnancy before a miscarriage, more pregnancies end in loss than is commonly believed.”
From an awareness perspective, says Dr. Sharp, it is beneficial to see intense media coverage of miscarriages experienced by celebrities such as Michelle Obama or Mark Zuckerberg’s wife, Priscilla Chan. On the other hand, adds Dr. Sharp, such sizeable coverage may reinforce the myth that pregnancy losses are extremely rare.
Doctor Experienced Loss Herself
Speaking at an October 2018 University of Wisconsin Department of Obstetrics and Gynecology community event, Dr. Sharp talked about pregnancy loss, including a deeply personal account of the loss of her own baby in 2013. Five years into her career as an obstetrician-gynecologist, Dr. Sharp was 18 weeks pregnant at the time. Following an ultrasound, she and her husband Brian learned that their baby had multiple physical and mental anomalies resulting from a piece of an X-chromosome that duplicated itself, causing more than 2,000 extra genes. She decided to have labor induced at 20 weeks, knowing that the baby, whom the couple named Caleb, would almost certainly be stillborn.
Dr. Sharp and Brian were unprepared and devastated.
“We spent 3 hours with Caleb before we had to say goodbye to him,” says Dr. Sharp. “We held him and kissed him and had photos taken with him. I thought that would be the worst day. How little did I know that it would get harder before it would start to get better. It actually made me feel embarrassed to be an OB/GYN, not having previously known what some of my patients go through themselves after a loss.”
About two years after losing Caleb, Dr. Sharp decided the time was right to turn her own loss into something that could help others who’ve had a similar experience. After reading many books and speaking with experts on the topic, Dr. Sharp created the UW Health Hope After Loss Clinic.
“My focus is on what these women have gone through,” says Dr. Sharp. “Some of my patients know about my loss, but I never bring it up if I feel that it might detract from the woman’s own situation.”
Many decisions about a lost pregnancy are incredibly difficult. These include whether to name the baby, deliver the baby knowing he or she will not survive, or to schedule events such as a baptism or funeral.
“I always encourage families to spend some time holding their baby and have photographs taken. Even if you decide to never look at the photos, at least you will have them should you ever change your mind.”
Misunderstandings About Grief
Grieving the loss of a pregnancy takes its own unique path for every woman and partner. Those who wish to provide support are advised not to make assumptions about what the grieving woman and partner are feeling. Asking, rather than assuming, is always the better way to go.
Phases of Grief
It is not uncommon for women to heavily grieve the loss of a pregnancy for up to two years, or even longer. Common phases of grief, which do not necessarily come in sequence, include:
- Shock and numbness (first 2 weeks), often characterized by:
- Difficulty concentrating
- Impaired decision-making
- Short attention span
- Searching and Yearning (2 weeks to 4 months), often characterized by:
- Preoccupation with the loss
- Physical signs, such as palpitations, fatigue, headaches, aching arms
- A sense that “I feel like I am going crazy”
- Guilt, Depression, Disorientation (3 to 9 months), often characterized by:
- Jealousy/Envy – especially seeing friends who have babies or are pregnant
- Social withdrawal
- Depressed mood
- Being disorganized or forgetful
- Physical symptoms, such as fatigue or weight changes
Many women, says Dr. Sharp, reach their lowest point during this 3- to 9-month phase.
“That is typically the time when many women return to work and experience social pressures to ‘get over’ their loss and ‘move on.’ It is also the time when support from friends and family typically wanes.”
- Reorganization/Resolution (10 to 24 months):
- Grief does not end, but becomes more manageable
- Integration of the loss into life
- Renewed sense of energy
- Better sleeping and eating
- Planning for the future
Triggers of Grief and “Mailbox Bombs”
Like what happens following any major loss, feelings of grief can sneak up at any time after a pregnancy loss.
“Routine daily experiences, such as seeing a couple with their baby in a stroller, or walking past the diaper aisle at Target, can instantly trigger sadness,” says Dr. Sharp. “Going to the mailbox can also be hard, especially when opening a ‘mailbox bomb’ such as a baby shower invitation or a coupon for baby products.”
Moreover, an innocent and very common question from strangers – “How many kids do you have?” – typically leaves parents of a lost pregnancy in an emotional bind.
“You can provide the honest answer, which can be very awkward, or the easy answer, which can trigger guilt for not recognizing the baby who died,” says Dr. Sharp.
Tips for Surviving the Loss of Your Baby
While there is no magic formula to ease the pain of a lost pregnancy, Dr. Sharp offers several ideas that many families have found helpful.
“Above all,” she says, “I advise women to be kind to yourself and to get support. Fortunately, there are many resources available.”
Among these are:
- Your medical provider. Be honest about your needs. If you’re struggling, don’t hesitate to say so.
- Counseling. Well-trained therapists offer a place to share your experience with an objective, supportive listener.
- Support groups. In the Madison Area, some options include:
- UW Health’s Hope After Loss Clinic, led by Dr. Sharp and Julianne Zwiefel, PhD
- Bereaved Parents of Madison <
- Hugs Program
- Mikayla’s Grace
Suggestions for Family and Friends
Interactions with family and friends can be touchy, because they typically want to help but don’t know what to say.
“Expecting people to truly know what you are going through isn’t realistic,” says Dr. Sharp, “so I encourage women and their partners to be as open and honest as possible. If someone says something unhelpful such as ‘Everything happens for a reason,’ there is nothing wrong in calmly saying why this is not supportive.
Other tips for friends and family members include:
- Be present for the long haul. Don’t fall off the radar of the grieving woman after the first month.
- Listen more than you speak.
- Don’t be afraid to use the baby’s name.
- Remember that there is no timeline for grief.
- · Don’t forget the woman’s partner, who is also grieving heavily.
Pregnancy After Loss
More than half – and as many as 80 percent – of women who lose a pregnancy will become pregnant between 12 to 18 months after the loss. Even if everything turns out normally – as is most often the case – it doesn’t make the pregnancy any less of an emotional ordeal.
“Pregnancy after loss takes a large emotional toll,” says Dr. Sharp. “Intellectually, we know that most of these pregnancies will turn out just fine, but there is no getting around the tendency to worry about what might happen.” she says. “I encourage women in this situation to ask for any measures – such as extra ultrasounds -- that can provide peace of mind.”
At a minimum, says Dr. Sharp, most families who experience a loss hope for two things:
- They will survive the loss
- Their baby will not be forgotten
Many families also will try to have another baby. Fortunately, the odds are very much in their favor.
“One miscarriage or even two does not increase the risk of another,” says Dr. Sharp. “I have been very proud to deliver healthy babies to many women who have experienced an earlier loss.
Finally, Dr. Sharp offers this comforting message from Sherokee Ilse, a well-published author on loss and healing:
Tomorrow will come. The pain will ease. But you will never forget your precious child. It takes hope and time and love for the healing to take place. Remember along the way to accept, but never ever forget.