The funny thing about miscarriage and pregnancy loss really isn't very funny at all. It's a cruel irony that, despite how common it is (about 1/4 pregnancies end in miscarriage, and those are only the reported ones), many women feel alone—even high profile women like Michelle Obama, who recently revealed that she experienced a miscarriage and needed IVF to conceive Malia and Sasha. And the research also indicates that a majority of women experience shame, blame, and guilt following pregnancy and infant loss.
And further isolation can set in as people tend to avoid discussing the topic. Perhaps it's out of fear of upsetting a friend further, or exploring a topic that may create some awkward tension. But that's completely backwards, I learn, when I speak with Jessica Zucker, a clinical psychologist and writer based out of Los Angeles. Zucker specializes in reproductive and maternal mental health, and has created a movement of her own with the birth of her Instagram account @ihadamiscarriage, in which she creates a safe space for discourse, sharing, and grief.
"Miscarriage and pregnancy loss such as stillbirth is not something that is talked about," says Zucker. "There isn't a clear path of what to say and what to do." And it's a grander problem as our culture in general is not necessarily comfortable talking about things that relate to death, says Zucker. But for a death that is expected (such as an older person or a grandparent), there are rituals and rites that exist. "When it's an out of order loss, where nobody else knows this potential baby, people tend to shy away from engaging the discussion about it."
Often well-meaning strangers and loved ones want to say the right thing and don’t mean to say the wrong thing, but sometimes that just happens. So what are women left to do? You can seek the support of a psychologist to help you process the pain and other feelings you're experiencing. "A lot of the conditions related specifically to women are dismissed," says Jessica Zucker, when referring to the support portals available to women who have suffered a pregnancy loss. In some cases (and depending on where you live), women who undergo a miscarriage and go to the hospital are offered a pamphlet with tips on getting through the physical process. Some of these fact sheets identify potential feelings such as sadness, anger, disbelief, disappointment and a sense of isolation. In other cases, women are referred to a psychologist or therapist from their doctor, midwife, doula.
1. Acknowledge the process: "Grief has no timeline," says Zucker. "One day someone can be feeling fine; then next day, they might feel horrible. Grief is unpredictable."
2. Talk, and talk some more. Zucker spends the majority of her time counselling grieving women, so she knows the importance of this. Skirting the issue will only exacerbate it, she says. "If you talk to enough women, I would say more women than not would agree that it’s not upsetting to bring something up that’s a reality of their lives."
3. Question things differently. Blaming oneself is extremely common, says Zucker. But trying to help people consider how they think about what happened can be very helpful. In her clinical practice, she urges women to look at the other side of the coin. "Instead of 'What did I do wrong?' I ask women, 'But what if you did nothing wrong? What if you did nothing to deserve this? And what if this is not a fault of your own?'"
4. Lean in. "It doesn't help to deny your own feelings," says Zucker. "It actually serves to make the grief stick around even longer when we try and ignore it." A lot of the time, women are looking to return to the way they felt before the grief set in, saying things like "I just want to get back to where I used to be."
5. Know the stats. As easy as it is to blame yourself, research shows that 80% of miscarriages are related to chromosomal issues. "And none of the research shows that women are creating their own losses," says Zucker.
6. Shift the blame: "A lot of people feel inclined to blame themselves, because in a way, it at least gives them agency, even though it’s in a negative direction," says Zucker. "They may then feel like, in a way, 'In my next pregnancy, I’ll do it differently.' It's a false sense of control because we really don’t have control over chromosomes."
If you're feeling alone and isolated, you can reach out to two organizations Knix is working with to help connect women with resources and support. If you live in the United States, visit Resolve.org, and if you live in Canada, check out FertilityMatters.ca.