The emotions tied to a miscarriage or stillbirth are undoubtedly profound and can be very difficult to deal with without an adequate support system in place. Like any other tragedy in life, one of the best forms of therapy is talking, particularly with the people closest to you and the ones you love.
Dealing with a miscarriage or having a stillborn baby leaves deep and often permanent damage because the woman has mentally and physically prepared herself to be a parent, which is ultimately taken from her. When this happens, it opens up a type of grief that has never been experienced and is extremely difficult to manage or move on from.
When it comes to supporting a friend or loved one who has had a miscarriage or stillborn child, it doesn't mean your role is to mitigate that grief; instead, it is a way to help manage and alleviate it. We can appreciate how difficult it can be, and often saying the right thing can be a challenge. The purpose of this article is to guide you on how to support a family member or friend through such a difficult time.
What Is A Miscarriage?
A miscarriage, also known as spontaneous abortion, is a medical term that describes an event in life that a pregnant woman directly experiences. This event results in the loss of a fetus before 20 weeks of gestation. It typically happens in the first trimester, between the first three months. According to recent data, between 10 to 20 percent of pregnancies end in a miscarriage.
Keep in mind; this number is presumably higher since miscarriage can happen very early on before the woman knows she is pregnant. In this case, it can go unnoticed and unreported.
Many soon-to-be parents are on high alert during this phase of pregnancy and do everything they can to prevent a miscarriage. Unfortunately, there is not much a pregnant woman can do to prevent it because most of the causes are out of their control.
If a pregnant woman is classified as a high-risk pregnancy, her family doctor, obstetrician, or midwife will monitor her closely for prevention, but many factors are uncontrollable.
ISSUES WITH GENES AND CHROMOSOMES
In the science and medical community, a great deal of data suggests that most miscarriages are caused because the fetus is not developing as it needs to be. On average, 50% of all miscarriages are caused by missing or extra chromosomes in the fetus.
While there are advancements in this gestational medicine, there is no way to prevent this. It happens entirely by chance, altogether unrelated to something the mother may or may not have done. The remaining 50% is related to health issues and lifestyle choices.
CONDITION OF MATERNAL HEALTH & WELLNESS
Below is a list of potential causes of miscarriage.
- Hormonal Irregularities or Imbalance. This occurs when the bloodstream has too much or too little of a particular hormone.
- Severe Organ Disease: This can be congenital or acquired. Either way, if it is detected and diagnosed during or before pregnancy, it is always a cause for concern for the pregnant woman and her doctor.
- Prepregnancy and Gestational Diabetes: When diabetes or early-onset gestational diabetes is diagnosed, it can cause a buildup of increased amniotic fluid, which can lead to severe complications, up to a miscarriage.
- Maternal Age: Studies indicate that the older the maternal age, the higher the risk associated with chromosomally abnormal eggs, which has been correlated with an increased risk of miscarriage.
- Cervix & Uterine Concerns: According to recent studies, up to 18% of pregnant women with uterine or cervix abnormality will suffer reoccurring miscarriages.
What Is A Stillborn Child?
A stillborn child is classified as the death of a baby that occurs before or during labor. While stillborn is similar to a miscarriage in that it is the unfortunate event of the premature loss of a fetus or baby's life, the distinct difference is when the loss occurs.
A stillbirth is recorded won or after 20-weeks of gestation. In the U.S., as many as 24,000 babies are stillborn; that's roughly 1 in 160 pregnancies. Despite the relief of graduating from the first trimester, there is an added fear of the baby being stillborn.
Fortunately, the medical field has advanced tremendously in prenatal care resulting in a reduction in the number of stillborn babies.
Like miscarriage, there are controllable and uncontrollable factors that increase the risk of stillbirth for some reason or another. Below is a list of the more common and identified causes.
- Women who are over the age of 35
- Multiple birth pregnancy (two or more)
- Having experienced a previous pregnancy loss
- Women of low socioeconomic status
- Women with poor medical conditions such as diabetes, high blood pressure, obesity, and organ disease.
Is Grief Different When You Lose An Unborn Child?
While there is a lack of medical research on the emotional and psychological effects of losing an unborn child, there is a general understanding of how grieving the death of a baby differs from other traumatic life events.
Studies have shown that the highest prevalence of complicated grief is from perinatal loss (the loss of an unborn child), including miscarriage and stillbirth. While everyone grieves differently, there is a similarity in how a parent who experienced the loss of an unborn child will experience grief.
GUILT
One of the most significant factors in the prolonged grieving process is the feeling of ambivalence and self-blame. It is not uncommon for the grieving parent to overanalyze everything they did leading up to the loss and question what they did to contributed to it.
This differs from other forms of grief as guilt is not always a common feeling that accompanies other types of grief.
PHYSICAL & BIOLOGICAL INABILITY
The belief that your body failed you and you are incapable of carrying a healthy baby, full-term can have long-term damaging psychological effects. This is another factor in the perinatal loss grieving process that differs from many other forms of complicated grief.
Women feel as though they are inadequate. In addition, studies have shown that some women will develop "child envy"- the feeling of being envious of other people's children. This is a side effect that comes with the grieving process, and if not dealt with, can worsen the mental and emotional state of women and prolong the grieving process.
Women who struggle with this will often distance themselves from friends and family members who are pregnant or who have children. While wanting distance is a normal response to all types of grief, it differs with perinatal grief as women often want space particularly from friends and family who are pregnant or have young children.
INABILILTY TO SAY GOOD-BYE
When it comes to experiencing the loss of a family member or friend who lived life and who you had the opportunity to know, there will be an opportunity to say goodbye at one point. Be it at the wake and funeral service or during their last moments.
This opportunity is generally associated with a positive death experience for the bereaving person. In the case of perinatal loss, particularly with a miscarriage, there is often no funeral or acknowledgment of the passing. This is shown to complicate further, prolong the grieving process, and leave the parents isolated and alone.
As exemplified above, the grieving process in perinatal loss is very different and can be difficult for the mother and father to manage. Having a support system to talk about grief will undoubtedly aid in the process.
Are There Early Signs To Detect Miscarriage Or A Stillborn Child?
There are some early signs to detect a miscarriage and stillborn death, but the cause is unknown in many cases, and often there are no signs to indicate the event.
MISCARRIAGE
Severe Cramping and Pain: In most cases, the severe cramping is prolonged and becomes unbearable. This is one of the more common signs of a miscarriage.
Bleeding: Minimal and infrequent bleeding is often little cause for concern during pregnancy and is common in the first trimester. However, when the bleeding persists and goes from a thin to heavy consistency, it can indicate a miscarriage is occurring or about to occur. Moreover, this is often accompanied by a fluid or tissue discharge.
Elevated Back Pain: This symptom will often accompany severe belly and abdomen cramping and is often associated with a sign of miscarriage.
Remember that these symptoms are not always a sign of miscarriage but should always be taken seriously. If you experience any of these symptoms and do not feel well, contact your health care provider (family doctor, midwife, or maternity doctor) right away or go to your nearest emergency room for an immediate medical consultation. Seeking medical advice is always in the patient's best interest.
STILLBIRTH
Like miscarriage, some women do not experience any symptoms; and everyone's experience is different. However, a few common symptoms often indicate a stillbirth is occurring.
Severe Cramping and Pain. Cramps and pain are usually symptoms of the uterus expanding, which is typical and expected in pregnancy. However, if the pain is severe and long-standing, it may be a symptom of stillbirth and is often the more recognized sign.
Bleeding and Discharge: While mild bleeding and discharge can be expected in the first trimester, that is not usually the case in the second or third, which is when a stillbirth will take place. If this does occur, it is a significant indicator of a stillbirth.
No Fetal Movement: This can be difficult to identify because the mother does not always feel the fetus's movement depending on their placement in the uterus and where the placenta is located. However, most women will feel movement after 20 weeks of gestation, and if they abruptly stop, it may be an indicator of stillbirth.
If a stillbirth occurs, a doctor will either need to perform a medical procedure or deliver the baby, which will need to be addressed as soon as possible. Therefore, if you experience any of these symptoms and do not feel well, contact your doctor right away or go to your nearest emergency room for an immediate medical consultation.
What Types Of Aftereffects Can The Family Expect After A Miscarriage Or Stillbirth?
When a miscarriage or stillbirth is experienced, the pregnant mother is not the only one who grieves. In fact, the entire family feels the anguish and mourns the loss. Everyone will deal with the loss differently and at varying degrees, but a few common emotional and psychological aftereffects accompany such a loss.
DEPRESSION
Although the pregnant woman has formed the initial bond with the baby, the entire family also creates a bond. When a miscarriage or stillbirth occurs, a natural response is to feel sad and depressed due to losing a family member.
Moreover, when one family member feels depressed over a shared loss, it is much more likely for the others to adopt this level of grief. This is why it is vital that the family talk about their grief rather than ignoring it.
ANGER & RESENTMENT
This is a natural response to grief, but in the case of perinatal loss, it can be much more prevalent toward others who are pregnant or who have children. This side-effect is challenging to move from because the more the mother sees and interacts with friends and family who are pregnant or who have children (which is difficult to escape), the longer it may take to heal.
Often, it can be a healthy choice the create some distance for a period of time.
FEAR OF MOVING ON
This is a familiar feeling shared among the entire family. It is often the case that the family feels guilty for moving on and finding peace again. Moreover, the mother can be afraid that if she moves on, it will appear as though she moved on from her deceased baby, which can cause mixed emotions.
A healthy acceptance of the loss is the best approach in this situation and may require professional therapy.
ANXIETY
A common side-effect among women who experienced a miscarriage is generalized anxiety disorder (GAD). She may develop a fear of repeated miscarriages, further medical procedures during pregnancy, or underlying medical conditions that harm a pregnancy.
This can manifest into sleeping problems, irritability, fatigue, and much more. Consequently, this can impact the family and cause further issues. If GAD becomes an impediment on the family or the mother’s life, professional therapy should be seeked.
Tips For Supporting A Friend Or Loved One That Has Suffered A Miscarriage Or Stillbirth
It is not uncommon to know someone in your inner circle, be it a family member or friend, who has suffered a perinatal loss; therefore, it is important to understand how to support them during their loss.
As we know, in the past, it was the cultural norm for soon-to-be parents not to talk about their loss. Even more, most newly pregnant couples still choose not to share the news of being pregnant until after the first trimester due to the high probability of miscarriage.
Fortunately, collective society is shifting and becoming more compassionate and we are not only normalizing miscarriage, but also creating an open environment for grieving partners to talk about their loss openly. Below is a list of tips to help you support your family member of friend during a loss.
ACKNOWLEDGE THE LOSS & VALIDATE THEIR EMOTIONS
Acknowledging and listening to someone speak about their perinatal loss is far more difficult than we may think. A typical response to tragedy is tuning out the details to save our minds from absorbing some of the pain, and that is understandable.
However, actively listening is the best way to acknowledge someone's pain and suffering and validate their emotions. It is often a better form of expressing our condolences than offering words of comfort because words can be misconstrued.
In many cases, the best way to acknowledge someone's loss is to listen, allow them to talk, and express every bit of sorrow and grief they have because it is essential to communicate grief as part of healing.
You can validate someone's emotions by letting them know that their feelings are, in fact, valid. Failing to validate their feelings is equivalent to invalidating their loss, which should never be done when it comes to tragedies like this. Furthermore, you want them to know that you understand their feelings by displaying sympathy. You can do this by being open and curious about their feelings and by asking appropriate questions.
BE THERE TO LISTEN, GIVE HUGS & LET THEM CRY
Being a good and empathetic listener is not the easiest thing for many people. It may be something you need to work on, which is okay. But ensure you open yourself up to listen so your loved one can cry and relieve some of their stress.
Below are a few ways to show them you are available to listen.
- Contact them as soon as you can, following their miscarriage or stillbirth. If it is too early to talk, they will let you know.
- Let them know you are concerned with how they feel and open the floor up for them to talk. Show active body language such as facing them and nodding your head in agreeance. Moreover, keep your phone at a distance so it does not interfere with the conversation.
- Set a date and time for you to visit them. Allow this to be their time to talk and cry as much as they need. When visiting in person, showing physical support such as hugging is an excellent way to let them know you care and are there for them.
- When the conversation comes to a close, set another date and time to get together or let them know you're available to talk on the phone when they need.
OFFER TO HELP WITH DAILY CHORES & TASKS FOR A BIT
It can be painfully difficult to get back to household routines, including cooking and cleaning, when someone goes through any tragedy. When it comes to complicated grief, there are many impediments that one will face, which can ultimately create a more difficult life circumstance.
The inability or lack of interest to engage in normal daily activities such as going to work, cooking, cleaning, and socializing is often a side effect. Offering your loved one help with cooking and cleaning can be an immense help.
If your loved one refuses this, offer to run errands for them and drop off food when you can. Always try to keep your offer on the table.
OFFER TO HELP WITH THE KIDS IN THE HOME SO MOM & DAD CAN TAKE TIME TO GRIEVE ALONE
When parents are grieving together while other kids are in the home, it can be a difficult journey to get through as they have so many other obligations. As we mentioned above, coping with the loss will often result in the parents needing time alone to heal and come to terms with their new reality. Moreover, if mom and dad are struggling to meet the needs of their children, the best way to address this is for them to seek outside help.
You can help by leaving an open invitation for them, letting them know that you are willing to take the children out, bring them to appointments, help them around the house, and do anything else you feel capable of doing. Offering this can make a world of difference.
OFFER TO HELP SET UP A MEAL TRAIN
A meal train is a coordinated effort between multiple people to prepare and supply meals for someone or multiple people during a difficult time. The purpose of doing this is to ensure your loved ones and their family members are eating during a time of grief and hardship.
This is particularly important because it can become challenging to prepare meals while coping with a recent loss.
The best way to approach this is to kindly offer your efforts, and leave it an open invitation if they initially decline. In many cases, people are too prideful to accept help in the beginning stages. Still, over time when life's necessities are being neglected, it's nice to know you have support waiting to help when needed. You can get in touch with other family members and close friends who will be willing to participate and set up a schedule in the event your offer is accepted.
SEND A CARD OR FLOWERS
Sending a card or flowers is a traditional practice and is always accepted as a kind gesture. If you live in far proximity of your loved one, this is an excellent way to show them that although they are not close by, they are still on your mind, and you care. Even if you live nearby, you can have them delivered if you don't feel comfortable visiting right away, or you can drop them off yourself.
GIVE A SMALL GIFT
Surprising our loved ones with a gift will warm their heart and provide them with a lifetime memory that they can hold onto. We listed a few excellent options below to get you started.
- Photo engraved necklace of the sonogram
- Photoframe with sonogram photo
- Cremation necklace
- Jewelry made from ashes
- Memorial jewelry with the name engraved (if the name was picked out)
If you're interested in learning what some of the most popular memorial gifts are, visit cremation jewelry for creative ideas!
IF THE PARENTS PICKED OUT A NAME, USE THE NAME TO VALIDATE THE CHILD
When a parent names their child, they give them their identity that signifies their living presence on earth. A lot of thought goes into naming a baby, and it has value. When talking to your loved one about their deceased baby, you must refer to them by their given name. You shouldn't do this only if the parents request not to do so. It can be painful for some, so be prepared to read their reaction when using the name and be respectful of their wishes.
You can learn more about how to support your family member or friend during the loss of a loved one.
Tips For The Family To Heal Together After A Miscarriage Or Stillbirth
Often we forget that in situations like this, the surviving children are also grieving, and they can sometimes feel neglected. The best practice is finding time to participate in healing as a family, which can come in many different forms, depending on the family and what works best for them. Below are a few valuable options.
TAKE THE TIME & SPACE TO HEAL TOGETHER
One of the most effective ways to aid in and expedite healing is to do it as a group. The grievers will have opportunities to share their feelings and hear how everyone else is dealing with the loss. A good strategy is to reserve some time periodically (daily, weekly, monthly) and use it to talk about the loss.
ACKNOWLEDGE THAT THE PREGNANCY EXISTED
Traditionally, most soon-to-be parents keep the pregnancy a secret until they've reached the second trimester. The problem with doing this is that if a miscarriage does occur, it leaves the parents grieving alone. It is difficult to ask children to accept their parent's grieving when they are not fully aware of what happened. Take some time to discuss the pregnancy and what happened. Talk about the hopes and dreams you had for your unborn child and help your children bring it to life in their minds.
HONOR THE BABY WITH A FAMILY MEMORIAL
We mustn't forget that the loss of an unborn baby can feel akin to losing a living child. Acknowledging the loss for what it means is essential in the grieving process. If this looks like memorializing the baby with a burial or ceremony, this is something you might want to consider. Moreover, if you want to create an online memorial, this is also a lovely option and is becoming a common practice with perinatal loss. If you are interested but don’t know where to start, we have a comprehensive guide that can help you.
HONOR THE BABY WITH A SPECIAL DONATION TO CHARITY
When a funeral occurs, many people will request their family and friends donate to a charity in lieu of buying flowers or gifts. This practice is done in the name of honoring their deceased loved one. The same approach can be applied when honoring the loss of an unborn child. Parents can do this as a family, and they can request their friends and family to do the same. They can pick a charity of their choice and make their donation. Adding your deceased child's name as the donor is an excellent way to honor them and keep their memory alive.
CONTINUE TO PRACTICE SELF CARE AS A FAMILY
Spending quality time together as a family is an excellent way to practice self-care. This opens open time and opportunities to talk about what is on your mind and provides a support system. Moreover, it creates opportunities to talk about family feelings, which can help parents address questions or concerns their children may have related to their feelings of losing their unborn sibling. Lastly, another excellent way to practice self-care as a family is to incorporate exercise or activities in the sun. Numerous studies demonstrate an improvement in mood with exposure to the sun which provides you with vitamin D.
WRITE ABOUT YOUR BABY
Over time, we tend to forget our thoughts and feelings from important times in our lives. A loss in the family is a harrowing tragedy to go through, but it can be helpful for us to write down our thoughts and feelings as a form of therapy and for future memory. This can be an excellent family project that allows everyone to participate. Every time someone feels down or struggles with their feelings, they can add to the notes and continue for as long as needed. It will also make for a journal to look back on if and when everyone is ready.
Other Valuable Resources For The Family To Use During This Difficult Time
Some moms and parents prefer external resources to help with the healing process, and fortunately, there are many to choose from. The best part of external resources is gaining outside perspective and receiving tips and guidance from other parents who went through the same loss.
FIND A MISCARRIAGE SUPPORT GROUP/LOCAL OR ONLINE
Support groups are becoming prevalent in today's society, and fortunately, they can be found pretty much anywhere. If you prefer in-person, you can do a google search for perinatal loss support groups, and you will be presented with options. Alternatively, Facebook is an excellent starting point if you prefer online support groups. However, if social media is not your preference, you can search for private online support groups. The convenient aspect of online support groups is that they are not restricted to one local community, meaning you will be part of a diverse community and learn about many unique experiences.
TALK WITH YOUR MINISTER OR PRIEST
As our social culture shifts and it is becoming commonplace to talk about what we previously considered taboo, perinatal loss, ministers and priests are becoming more accustomed and comfortable talking with grieving parents. This is a safe and private environment where you are encouraged to express your feelings and, in return, will be given guidance on how to cope and move forward.
FIND A BOOK ON MISCARRIAGE OR STILLBORN CHILD
You can visit your local book store or browse through Amazon for some of the best-rated books on perinatal loss. Some parents prefer not to open up to an external therapeutic source, or family member, which is okay. Books have abundant knowledge that can be utilized on your own time that doesn't require booking appointments or seeing people when you're not ready.
THERAPY/COUNSELING
Many workplace insurances offer counseling coverage, and if you have access to this and feel comfortable, you may want to take advantage. Receiving a one-on-one professional therapy session can enlighten the situation and quicken the healing process. You can also check with your maternity or family doctor on what free or low-cost therapy resources they can refer you to. For parents who are still struggling to move forward after attempting external resources, you may find this article useful in helping you move forward.
YOUTUBE/PODCASTS
Digital resources are the new normal for consuming content, including therapeutic and self-help material. YouTube can be an excellent resource as many women and parents upload videos of their personal experiences with pregnancy loss and offer insight into the world for them. Often, the best therapy is to connect with people who have experienced the same tragedies and traumas.
Miscarriage Frequently Asked Questions
What do I say to a friend who has suffered a miscarriage?
It can be challenging to know the right words; therefore, the best first approach is listening and acknowledging their loss. Give them your condolences and offer time to talk, giving them an outlet to express their emotions.
How do I support my spouse after a miscarriage?
The pregnant woman is more likely to feel a more profound sense of grief following a perinatal loss because of the emotional bond formed during gestation. You can offer support by sitting with her, allowing her to talk and express her grief. Giving her your time and actively listening while showing compassion is often all she will want from you. Moreover, discourage her from adopting the blame by reminding her the loss was out of her control.
Should a family have a funeral for a stillborn child?
Yes, this is something that is recommended. When a baby is over 20 weeks gestation and results in stillbirth, most state laws require you to have a funeral service involving either a burial or cremation. You can do this by contacting a funeral provider. Keep in mind; this is an opportunity for you to formally say goodbye to your baby so it can also be therapeutic for you and your family.
Should I offer to help babysit my friend's kids after she had a miscarriage?
Yes, this is highly encouraged and is an excellent way to support your friend through a difficult time.
How long does it take for a woman to recover from a miscarriage?
There is no specific time frame expected for women to recover from a miscarriage. It often takes longer than the physical recovery, but everyone's recovery time differs. This can depend on gestation age, the bond that was formed, the available support system, and many other factors.
Is there such a thing as miscarriage depression?
Yes. Sadness and grief are the usual and common emotional responses to a miscarriage, and in some cases, these emotions can develop into miscarriage depression. Miscarriage depression is persistent and intense feelings of sorrow associated with the loss of a child, and a mental health practitioner should always be consulted.
What causes a baby to be stillborn?
According to updated medical studies, ⅓ of stillbirths are unexplained, while ⅔ are caused by problems with the umbilical cord, placenta, high blood pressure, infections, birth defects, congenital disabilities, and poor lifestyle choices. In many cases, your doctor will inform you of complications that may exist and will encourage lifestyle changes if needed.
Is there a difference between stillborn and stillbirth?
There is no difference between stillborn and stillbirth. Stillborn is the adjective describing a mother who suffers a stillbirth.
Are there warning signs of a stillborn baby?
Stillbirth does occur without accompanying warning signs, but the main one is when you can no longer feel fetal movement. It can be difficult to recognize this, so doctors often instruct pregnant women past 28 weeks gestation to track daily fetal movement. An absent, mild, or high kick count should be taken seriously, and your doctor should be contacted.
Can stillbirth be prevented?
In most cases, no. However, the best way to reduce the risk is to measure and monitor the mother's health and lifestyle choices, including diet and managing preexisting conditions. All these efforts combined are the best preventive measure.
How soon after stillbirth can you try to conceive?
According to the World Health Organization, there is no recommended time frame to wait until trying to conceive. Consulting your family doctor and waiting until you’re emotionally and physically ready is what they recommend.
Beginning Again After A Miscarriage Or Stillbirth
It is important to remember that everyone's grieving journey is different, and some approaches will work better than others. If your family member or friend is experiencing grief that is impeding their life, being there for them is the best thing you can do to help them during this difficult time.
The biggest takeaway is acknowledging their loss and being a good listener. Many resources are available, so recommending a few is another way to show you care. There is no right or wrong way when supporting a loved one; being there for them is more beneficial than you may know.
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March 31, 2022 by Jeri K. Augustus