Pregnancy loss - a uniquely private yet surprisingly common challenge
October is Pregnancy and Infant Loss Awareness Month and, unfortunately, pregnancy loss affects many of us in the infertility community. So, today, I wanted to share some information, reflections, and resources for those who have experienced this particular kind of loss.
The loss of any pregnancy represents a significant personal loss that deserves recognition and time to grieve. It can bring feelings of sadness, fear, and loneliness. For those struggling with infertility, these feelings are often amplified because the loss is coming after many other personal losses - feelings of loss or failure with each failed cycle, a sense of loss of control or agency to create the life you want, loss of faith in your body, etc.
Given the significant personal impact of pregnancy loss, perhaps one of the most important things to realize about it is that it is actually quite common. Miscarriage, the loss of a pregnancy before 20 weeks of gestation, occurs in roughly 10-15% of known pregnancies. Most miscarriages occur in the first 12 weeks of pregnancy but between 1 and 5% of pregnancies end in miscarriage between weeks 13 and 19. In total, 1 out of every 4 women will experience a miscarriage at some point during her reproductive years.
Stillbirth, a loss occurring after 20 weeks of gestation or during delivery, can be particularly hard to process. At this point in the pregnancy, most couples have come to trust that the pregnancy is progressing and started to plan for their baby’s arrival, including picking a name. Thankfully, it is also more rare. 1 in 100 or 1% of pregnancies end in stillbirth. For comparison, our average lifetime risk of dying in a car crash is also roughly 1%.
However, despite the prevalence of pregnancy loss, we often struggle to find ways to process the experience. Perhaps this is because pregnancy loss is a kind of “disenfranchised loss” - a loss that doesn't fit in with society's attitudes and norms for dealing with death and loss. We traditionally mark the death of a loved one in a public way. We hold a funeral or memorial and have the opportunity to share our grief with others. But we have no traditional way of marking the loss of a pregnancy. Worse, we often feel that we can’t share it with others. For example, it feels acceptable to tell our bosses and co-workers that we have had a death in the family and will be taking some time off. But, we rarely amit to needing time off due to a miscarriage if we even ask for time at all.
A sense of personal responsibility and feelings of guilt or shame may also impact our ability to recognize and grieve these losses. Many women, especially those struggling with infertility, feel shame that their body didn’t work as it is “supposed to”. Others may believe that they did something to cause the loss. Therefore, another important thing to understand about pregnancy loss is that the majority of losses happen because of random genetic mutations in the embryo that are incompatible with life. In order to become pregnant and have a healthy baby, a series of complex biological processes need to occur. But, many of these processes are inherently error prone. This is why pregnancy loss is so common. It is also why we need to stop associating these losses with blame, shame, and guilt.
So, if you have experienced pregnancy loss, here are a few things that might help you process the experience and heal.
First, know that you are not alone. Then remember that the loss does not represent any failing of you or your body.
Find a way to acknowledge the loss. Many couples find solace in lighting a candle on what would have been their due date or saving something from the pregnancy to memorialize the loss.
Seek support. Both Resolve New England and Resolve, the national infertility association, offer support groups for those experiencing pregnancy loss as well as those pregnant or parenting after loss.
Finally, when and if you are ready, share your story. Not only does speaking out about your experience help others, it can also be an important step in healing - a way of finding strength and empowerment in your experience.