How to cushion the grief after a miscarriage or losing a pregnancy

How Long Does It Take to Grieve After a Miscarriage?

Though a woman’s body usually heals completely four to six weeks after pregnancy loss, painful thoughts of what could have been may linger for years, or a lifetime. The traumatic experience of losing a baby is universal and as old as humanity itself, but every parent will react differently to a perinatal death—which means however you feel right now, it’s okay. There is no right or wrong way to grieve, just as there is no specific amount of time that grief is supposed to last.

One might assume that the longer you’ve carried a child, the more you will suffer from the baby’s loss, but research shows that there’s little association between the level of distress or depression you feel after a perinatal loss and how far along you are in your pregnancy.

There’s no way to force yourself to move on, nor should you try. The best thing you can do is let yourself feel it and work through it with the help of a mental health professional and a solid support system. A qualified grief counselor or therapist will be able to guide you through your grief and pain, offering compassionate support and a safe space to process all the hard things you’ve been going through.

What Mental Conditions Are You at Risk for After a Miscarriage?

The clinical term for the grief one feels after a loss such as miscarriage, stillbirth, ectopic pregnancy, or neonatal death is “perinatal grief.” Common symptoms of perinatal grief may include: 

• Intrusive thoughts
• Feelings of numbness
• Loss of identity
• Awkwardness and/or jealousy around other people’s children
• Anger
• Avoidance
• Yearning
• Disbelief

Studies show that many women also experience the symptoms of post-traumatic stress disorder after pregnancy loss. Intense grief is not unusual, especially in the first six months after loss, but sometimes grief can become pervasive and cause long-term impairment in functioning and mental health. The following risk factors can contribute to what’s called complicated grief, or prolonged grief disorder, after a perinatal death:

• Guilt. Parents who blame themselves for a perinatal loss may have more trouble managing their grief. In a tragic situation where there’s often no clear explanation for the loss of a pregnancy, many parents decide that they must have done something wrong. This kind of guilt is associated with complicated grief reactions.  
• Repeated miscarriages. If someone has experienced recurrent pregnancy loss, they may develop negative emotions about their bodies, feeling that they’ve somehow failed in their perceived biological roles. 
• Ongoing miscarriage symptoms. A miscarriage can be an extended process, which means that parents may not get closure overnight. For example, a pregnant person might begin bleeding but still have enough HCG hormone levels to produce a positive pregnancy test, or they may have an incomplete miscarriage and require a medical procedure like dilation and curettage (D&C). It can take weeks for the body to adjust to reality, which can feel both confusing and heartrending. 
• History of depression. People with a history of psychiatric issues like depression or anxiety are more vulnerable to complicated grief. People who have trouble with emotional regulation are also at risk.
• Family composition. People who have lost a pregnancy tend to experience more prolonged, disruptive grief if they don’t have existing children. 
• Lack of social support. People who don’t have friends, family members, or a supportive community to lean on in their grief tend to take much longer to heal.
• Pre-existing relationship difficulties. A pregnancy loss can aggravate existing relationship issues with your partner, turning what should be a source of support into a source of stress and conflict. 

The enormity of one’s loss doesn’t just manifest as sadness and grief; it can also show up as anxiety. Because 50-85% of women who have miscarried get pregnant again, they may feel increased anxiety, fear, or hyperarousal (a symptom of PTSD) during their subsequent healthy pregnancies, especially when their new child reaches the same gestational age as their previous loss. These women are also more prone to postpartum depression. 

Partners of the pregnant woman will also often experience feelings of loneliness or helplessness. Both parents need support and care during this turbulent time. 

Finally, it’s also okay to adjust quickly and easily, without emotional turmoil. There’s no wrong way to grieve these kinds of losses. 

How Do You Grieve the Loss of a Pregnancy?

As with any type of grief, the goal is not to fix it, but to find ways to go forward even when you desperately want time to stop or reverse. You can’t bring back your child and all the hopes and dreams that you’d harbored, but you can show compassion to yourself and your healing process through the following approaches:

• Self-care: After a miscarriage or another kind of perinatal loss, the grieving process must take place alongside the physical recovery process. You may have gone from taking excellent care of your body, knowing that you were carrying a child, to being angry at your body for not sustaining the pregnancy (even though it’s not your fault). But at this point, you have to remind yourself that you deserve care as well. Continue to eat well, take your prenatal vitamins, sleep, and exercise. Get the health care you need. Use your PTO. Let your mind and body work together to find a resolution.
• Couples therapy/marriage counseling: Research shows that pregnant people tend to become attached to their babies very early in their pregnancies, while their partners may not start to bond until about 20 weeks gestational age. This means that a miscarriage might elicit completely different emotional reactions from co-parents. Talking through these feelings and identifying them as normal and not pathological can help intimate partners reconnect and support each other. 
• Learning the facts. Though miscarriage can be traumatic, it’s incredibly common, and most likely out of your control.
• Telling or writing your baby’s story. You don’t have to give up the bonds you had with your baby. You can make personal meaning from your devastation. Even if you were never able to share memories with your child, you still experienced sharing a heartbeat, and there’s incredible beauty in that. Find a way to communicate and share the connection you had.
• Memorializing your loss. Humans have rituals for a reason. Perinatal death is often sudden, leaving you no time to prepare. But you can find a way to say goodbye. You may find meaning in planting a tree, holding a private ceremony, or buying yourself a small piece of art that speaks to your loss and hanging it where you’ll see it every day. You could also wear a piece of jewelry that reminds you of your baby, something you can touch when you’re in distress.
• Therapy/counseling. Professional therapists can help you truly feel your emotions, manage your anxiety, and modify any negative thinking patterns you might have regarding your loss. It’s especially important to talk to a licensed mental health provider if you have a history of depression.
• Human connection. Try not to self-isolate. Yes, the people in your life are inevitably going to say the wrong thing. Not everyone has been through what you’ve experienced, so that’s to be expected. But it’s far more difficult to recover alone. If you’re struggling to communicate your needs and wishes, enlist a close friend or family member as a spokesperson who can help you maintain your boundaries. 

Healing from Pregnancy Loss in Counseling

Healing from grief is not a linear process, even with the help of counseling. Though no one can predict how grief will hit them or how quickly they heal from it, grief counselors are the people best equipped to help you through this tremendously difficult time. 

Grief counselors will be able to tailor your care to your specific needs and concerns by working with you to set up goals and a treatment plan that works for you. They know exactly how unpredictable grief can be and can provide you with a space where it’s okay not to be okay. Though no one should have to face this kind of loss, the only way to move on from terrible grief is to go through it.