Understanding Pregnancy and Infant Loss

Trigger Warning: This article discusses pregnancy and infant loss.

If you’re pregnant, this might not be an article you want to read right now, but if you can, it’s great to have an awareness that some people are having a very different journey.

It’s hard to even consider writing this, to be honest. It’s much nicer to focus on the positive. It’s even easier to focus on the simple obstacles most parents will have to overcome at some point, and how we can help.

It’s much harder to think about what happens when things are not simple, don’t go well at all, and there’s nothing I can do but symphathize. But considering these things is important, whether you’ve gone through something discussed here or not. Truthfully, many people don’t know what to do or say to someone who is coping with grief or loss related to childbearing.

Loss at Conception

For some people, the grief and sense of loss comes before pregnancy. It can be such a crushing experience to discover that you can’t conceive normally. Most people do not think about the possibility of not being able to conceive on their own when they decide to become parents..

Some people do expect that it will take some time to get pregnant, but believe that it will happen eventually. In the worst case, they might expect to have to be a little more patient. Other people expect to get pregnant right away and then experience deep disappointment when it doesn’t happen during the first ovulation cycle.

For others, it doesn’t happen right away, and even with patience doesn’t happen at all. They might question their bodies, their health, their partners, or their lifestyle choices. This can bring on significant emotions of grief and loss. They have to face the loss of an idea, a plan, and a dream. They grieve the loss of a bodily function they thought they had and that they were counting on.

They sometimes decide to face the reality of Assisted Reproductive Technology (ART). Anyone who has decided to take this path could be experiencing a lot of big emotions, so I always assume that they are. ART is fairly common now, but it is always a big deal and should be handled gently and with compassion. If someone you know is trying to conceive using ART, recognize that they might be going through some big emotional turbulence.

Early Loss

An early loss is a miscarriage that happens in the first half of pregnancy. To start, I want to say that having a loss at five weeks can feel very different from a 20 week loss. It’s normal to feel different about it. During the first trimester (through week 12), people don’t look pregnant and don’t feel the baby moving. For the first six weeks, they may not even know they’re pregnant and likely can’t hear the heartbeat during an ultrasound. They likely won’t be doing much to prepare yet, and maybe haven’t told everyone about the pregnancy. Having a loss at this point can feel less impactful both emotionally and physically.

After the first 12 weeks though, they have likely heard the baby’s heartbeat, and may start to feel movements. Their body has done a lot to support the pregnancy. They will probably notice a belly bump by 20 weeks. They’ve also had a lot of time to process their new reality and might be getting excited and doing things to prepare to have a baby. A loss at this point might feel bigger.

But it’s also true that loss is subjective. For some people, having a very early loss can be devastating because they immediately started imagining a future with this baby. Or it might be especially hard if they had a long struggle with infertility.

For others, the loss might not register much at all, or can even feel like a relief if the pregnancy was unexpected or came at a stressful time. An early loss can even be missed. If a person isn’t tracking ovulation carefully, they might just think their period came a little late. At whatever point in pregnancy it happens, miscarriage is a common occurrence, happening in approximately 15-20% of known pregnancies. This is an estimate that is assumed to actually be higher, because many miscarriages happen without the person knowing.

Just because miscarriage is common does not mean that it’s not difficult or even devastating.

Stillbirth

Stillbirth is a loss that occurs when a baby dies in utero after 20 weeks. Like miscarriage, this is a very subjective experience and can feel very different depending on when and how it happens. This is often a very traumatic experience for parents. They may be offered options for birth and for whether and how they might want to see and hold their babies. Many hospitals have special rituals and procedures set up for this, and mental health professionals usually recommend that parents participate in some of them for their own grief processing and mental health. Having a full spectrum doula who is trained in supporting stillbirth can be so helpful.

NICU Stays

NICU stays are very common. Approximately 10% of babies will spend some time in the NICU. There is a big range of severity and experience here. A baby sometimes just needs a day under some special lights to help with jaundice. In other cases, a baby might need months of intensive care to survive being extremely premature or because of a severe birth defect or illness. A parent’s experience of a NICU stay is also very subjective. It might not feel like a big deal to some, but for most, it can be a very difficult experience. Most of us have a particular vision of what it will be like to give birth and meet our babies. When that doesn’t go as planned and a parent is forced to be separated from their baby, it can be quite traumatic. NICU parents experience the loss of a vision and the grief that goes along with that and for their baby’s condition.

Infant Loss

Finally, losing a baby that was born alive is at the end of this spectrum of loss. I’m sure that everyone can imagine this kind of loss. We all have to consider the loss of a loved one at some point. As a new parent, this might seem like the worst kind. It doesn’t happen often anymore, but it still does occur. Infant loss can happen for any number of reasons. There are countless illnesses, injuries, and accidents that can cause it, although it is still a very rare kind of loss.

What to Do if You Experience Loss

Our culture doesn’t do a good job of preparing people for loss. It is a very normal part of life, but we don’t have a lot of language for how to cope. Loss is often a topic of conversation that is avoided, especially around children, so we’re raised to not talk about it. The more we suppress it though, the bigger it feels.

I’ve experienced losses, and had to recognize that I wasn’t fully prepared, even with a degree in psychology. I learned about the full spectrum of human development, and grief management, and mental health, but I still didn’t feel prepared to cope with losses when they happened.

Especially for those who haven’t been prepared, I think it’s very important to feel the grief, and to allow themselves to get help. Some people can talk to friends and family or develop their own ceremonies and rituals of mourning. Others might belong to a religious community that has some death rituals which can be very helpful. I would definitely recommend getting professional help from a licensed therapist and also finding a support group. Meeting with others who are experiencing a similar loss can be so healing.

I’ve recently been grateful to the people who would talk to me about their own losses, because that made me feel so much more normal. I lost my mother less than a year ago, and it has been a learning experience for sure. I’m 48 years old. Even though my mom was only 70, it’s starting to be normal to lose a parent at this age. Many of my friends have lost older parents. Just because it’s common, doesn’t mean it isn’t earth-shattering every time. It’s very important to remember that. One of the most helpful things someone said to me was, “It’s just awful to lose your mom. It’s the worst.” It was the first time someone had really recognized that. I had been feeling like I should just be able to move on quickly because this kind of loss is expected. That doesn’t matter. It’s just hard and awful no matter what.

It can also be really helpful to talk to others to better understand how healing progresses. For example, talking to someone else who had lost a parent, I was able to understand that it was normal for me to not be able to put pictures of her up around my house. I was worried that I still couldn’t look at pictures of her. This person told me that she couldn’t do that for the first couple of years, but that now after four years, she’s actually started to get comfort from finding pictures of her dad to display. By telling me that, she gave me hope that I will be able to do that someday, and also made me feel normal for not being able to right now.

What to Say To Someone Else

If you don’t know what to say or do for someone who has recently experienced a loss, you’re not alone. I’ve been paralyzed before by not knowing how to support a friend through a loss. I was so scared of doing or saying the wrong thing, that I did nothing at all. I regret that, but I also know this happens a lot. I’ve learned many things since then, so I’ve listed some ideas that might be helpful. These come from hearing stories of loss and what these people wish others had been able to say to them or do for them. It’s important to recognize that these are recommendations for when a loss is new. After a little more time the grief will change, and other things will be helpful.

• I’m so sorry.
• It’s just awful. It’s the worst.
• This must be so hard. I’m so sorry you’re having to cope with this.
• I can’t imagine the pain you’re going through, and I’m here for you.
• I have no idea how you must be feeling or what to do, but I want to help you. Please let me.
• Send a card with your sweet thoughts in it. Tell them how sorry you are and how much you appreciate them and believe in them.
• Send food.
• Run errands for them.
• Listen. If they’re able to share, just listening without needing to say or do anything can be very helpful.
• If you knew their loved one at all, it can sometimes be helpful to say how that person had a positive impact for you. He was such a sweet baby. He always managed to make me smile.
• Just show up. This can be a hard one. People who are grieving may not be able to ask for support. They may even seem like they want to be alone, but then usually benefit from having people show up. You might not even need to do anything. Just sitting with them can be very comforting.
• Ask someone else close to them how you can help. Maybe they have a sister or close friend who they’re leaning on for a lot of support. That person might be able to give you some good ideas.

It’s usually not very helpful to try to “fix it”. People need to feel their grief and be supported in that. They don’t need to hurry up and get better. Anything that promotes NOT feeling it or recognizing how big the loss is will not be helpful for most people. With that in mind, many people report feeling overwhelmed hearing some of these things:

• Everything happens for a reason: They may be ready to hear that or believe it someday, but not usually when the grief is very fresh.
• They’re in a better place: This kind of reassurance might be helpful someday, but it also takes away from the fact that the person left behind is feeling a loss. It can often make them feel bad that they’re not feeling happier for their loved one.
• Your loved one would want you to be happy: This is another one that dismisses the reality and scope of their grief, and can even induce guilt. It might be helpful later when they are able to find some happier moments, but probably not at first.
• I understand how you’re feeling: You really might, but it’s probably not helpful for them to hear that. Most people feel like their grief is very personal.
• It’s also usually not helpful to ignore it. Some people benefit from being distracted from their grief by talking about other lighter things, but that is usually not very helpful.
• It might not be helpful to send grief-themed gifts. I’ve sent them myself, and I know I did that with the best intentions! But they can be triggering or even just something they have to figure out what to do with. It can feel overwhelming to receive these kinds of gifts. It’s usually better to find out what can be useful for them.

There is no “right” or “wrong” way to grieve or support a loved one who is grieving. Loss happens, and grief is part of the process. Sometimes, time is the only thing that truly helps with healing.

And we’re always here when people are ready to come back. This happens too, and we’re so honored to be part of the return journey. People can experience loss, then enter another pregnancy to welcome another child. There’s loss and redemption. Each baby is part of your parenting journey, whether in memory, spirit, or in physical form.

References

A National Survey on Public Perceptions of Miscarriage – PMC

The March of Dimes – Miscarriage articles

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