By Sharon Covington, MSW, LCSW-C

Introduction

The loss of a baby in pregnancy, whether early or late, is a profoundly sad experience. In a moment, your joyous hopes and dreams are turned to grief and despair, leaving couples feeling hollow and alone. Earlier in pregnancy, others may not have known you were pregnant while later in pregnancy, your baby is “known” but primarily to you and your partner. The fact that your loss is invisible to family and friends, is what makes it so difficult to grieve and mourn.

Grieving is the normal process of painfully releasing your connections to a loved one. When it occurs before a life has been fully lived, such as during pregnancy, you are grieving prospectively; that is, your are grieving the hope and dreams of what you believed was to come. Your dreams of the future and lost potential are not visible to others and you may find yourself struggling with these intense feelings alone. Thus, you may feel like your emotions are so out of sync with how the rest of your world is responding: that is, you feel like you are over-reacting, while the rest of the world seems to under-react. Nonetheless, grieving must be done and is the tribute you give to your baby’s life.

Grieving often feels like one is riding a roller coaster of emotions, with highs, lows, twists and turns, which are often difficult to anticipate or expect. You may feel better for a while, and then be overcome with a wave of sadness. Often these emotions are triggered by days, events or other reminders of your baby and pregnancy. As a due date or anniversary of your loss approaches, you may find that feelings creep up, almost like a shadow hanging behind, reminding you of what you have lost. Triggers are very personal and unique to your experience, an d might also include a special song your heard while pregnant, Mother’s Day or other holiday tied to your memories of this baby, or seeing a pregnant woman or infant. Despite feeling like a roller coaster, grief cannot be hurried or rushed along

Each person will grieve in his or her own way and time-frame, based upon personality and life experiences. Grief is highly personal and, unfortunately, no established guidelines can speed you through this healing process. While certain phases of grief are universal—shock, emotional anguish, and resolution—the feelings often reoccur over time and may reflect the depth of connection you have with the one you lost. With a pregnancy loss, several factors may contribute to the sense of loss you had for your baby and thus may intensify your grief. These include:

• Time—the longer you have been trying to conceive, the harder the loss may feel;
• Technology—the more advanced the technology used to achieve or maintain the pregnancy, the greater the emotional investment in the pregnancy and the greater the loss may feel;
• Age—racing against the biological clock increases the sense of pressure and connection;
• Gestation—feelings of attachment grow as the pregnancy progresses; and
• Multiple pregnancy losses—grief often builds with each loss as well as diminished confidence in a future pregnancy.
• Quality of Support —spousal, family, and extended family support.

All these factors impact grief and may help you understand why this loss feels so profound.

Grief is the emotional response to a loss; mourning is the way we deal with these feelings. With “visible” loses such as the death of a family member or friend, we have established rituals that facilitate and encourage mourning. Funerals, religious services, formal mourning periods, and memorials and memorial funds are some examples. It is useful for couples who have lost a baby to miscarriage to modify these rituals to help them cope with their loss. Variations of these rituals can help you acknowledge and validate your baby’s existence, and thus give you the “right” to grieve. Your ability to heal is directly related to your ability to grieve and mourn the loss of your baby.

Over the years, I have worked with many couples who have lost a baby in pregnancy or after birth. Although everyone responds in their own way and not everyone feels the need to perform rituals or make the baby seem more real, I have learned the importance of rituals and grieving activities for helping people mourn and mend their broken hearts. Rituals and actions that acknowledge this loss as real and worthy of mourning facilitate healing. The following are measures that some people have found helpful:

• Adapt mourning rituals that recognize your baby’s life. You may want to consider having a memorial service or religious ceremony for your baby, even if only you and your partner participate. Choose a special place, such as a beach or park you love, and read poems, prayers or letters to your baby that you can save or scatter into the water or air. Light a candle at your church or synagogue, or buy a special candle you keep at home and light in your baby’s memory. Purchase an item for a worthy organization, such as a toy for a children’s hospital, that reflects what your baby might have liked. Some women like to buy a charm or locket that they wear as recognition of their baby, as is done for new babies or living children.
• Do something physical to work through your emotions. Research suggests that physical activity and exercise helps people deal with feelings of depression and anxiety. It also provides the opportunity to work through your emotions while strengthening your body. Consider training to run in a race or walk for a charity event in your baby’s memory. Plant a tree that will bloom when your baby was to be born or cultivate a vegetable plot where you can work the soil, tend the garden, and see the fruits of your labor. Any physical activity that is goal oriented, with a beginning, middle, and end, such as running a marathon or climbing a mountain, is especially helpful.
• Use your creative ability to express your grief. When I have encouraged my clients to use some of their creative energies to work through their grief, I have seen the most inspired works of art. Make a scrap book or memory box of mementoes related to your baby, such as sonogram pictures, cards, or something you might have purchased for her or him. One father I know who loves to work with his hands crafted a memory box from wood. If you like to sew, make a quilt or other item to save or give to a charity in your baby’s memory. Drawing or painting, playing or composing music, or sculpting works that reflect your feelings about your baby help to give meaning to this life. Writing is also a compelling way to express feelings. It is important to find a way to say “goodbye” to your baby and writing a poem or letter can be a powerful method. Many have found keeping a daily journal of their feelings after a loss not only saves the precious memories that could be forgotten, but also helps you see your progress in your grief journey.
• Keep in mind that “A feeling shared, is a feeling acknowledged.” Talking about your loss and grief are a fundamental part of the healing process. Having shared in this experience with you, your spouse is often the one you turn to for support and understanding. However, when both of your are grieving (sometimes doing it in very different ways), it can be challenging to be there in the way each of you needs. Acknowledging and accepting this issue is important in the health of your relationship. It is also important to find other understanding people to whom you can express your feelings. You need to be able to talk about your grief with those who truly understand…”
•  It is most important to find understanding people to whom you can express your feelings. You need to be able to talk about your grief with others who truly understand, which helps validate your feelings. At times, family and friends are not able to understand the magnitude of this loss and you need to find other empathetic people. Pregnancy loss support groups, Internet chat rooms dedicated to the subject, and counseling with a mental health professional with special training in pregnancy loss grief are excellent resources. You may, also, want to educate your family and friends on the deep grief of such an invisible loss —to help them understand your needs, and that your strong emotions are normal and, indeed, healthy. You may want to give them articles such as this to help them in this process.
• Find a way to connect meaning to your baby’s short life. While the loss of your precious baby is filled with enormous sadness, it is important to find purpose and meaning from this experience. Very likely, you will not discover this immediately and it may appear to you over time. It is what I call “the gifts” your baby gives you. For some people, the gift is engaging in therapy and working through problems of the past, related or unrelated to their lost baby, which allows them to find happiness in everyday life, despite their loss. For others, it may be getting involved in organizations or support groups like RESOLVE: The National Fertility Association (www.resolve.org) , which can provide new insights, offer new relationships or help build new skills that last a lifetime. Be aware that your baby, though invisible to others, will always live on in your heart and let your tribute to his or her life bring out the best in you.