How can I cope with pregnancy loss? | Ask Dr. Domar

Although pregnancy loss is incredibly common, many individuals who experience miscarriages don’t expect it to happen to them. 

If your thoughts jump quickly from seeing a positive pregnancy test to dreaming up baby names, nursery decorations, and clever ways to tell your family and friends, you’re not alone. When those happy fantasies are brought to a sudden halt, it can lead to intense feelings of grief, sadness, isolation, jealousy, and anger.  

Up to 25% of all pregnancies end in loss. But as I’ve learned from my patients, this statistic may not lessen the pain. It doesn’t matter if this is your first pregnancy or your wanted fifth pregnancy after giving birth to four healthy children — the feelings of loss are the same.  

Miscarriage can be even more distressing for individuals who have experienced multiple losses or pregnancy loss after fertility treatments than in individuals who conceived on their own. One miscarriage can seem “normal,” but having two or more can make you feel as if there is something wrong with you or your partner. If you have had two or more losses, it is important to see an infertility specialist who can determine the next best steps for attempting pregnancy again. A hopeful fact to keep in mind: even if you have experienced three or more losses, the odds are still in your favor for your next pregnancy to result in a healthy baby. three or more losses, the odds are still in your favor for your next pregnancy to result in a healthy baby.  

Pregnancy loss is a singular experience.

Those of you who have lost family members or close friends may notice that this loss is different. There are no memories to cherish, no funny stories to share, and no established rituals for mourning in most cultures. And since many people who are pregnant don’t “tell” until they are past the first trimester, support from family and friends is also often lacking.  

Research shows that many women who have had a pregnancy loss are at risk of becoming depressed. Unfortunately, 66% blame themselves for the loss. Hopefully your physician has already told you this, but let me reassure you: a miscarriage is not your fault. There is essentially nothing you can do, or fail to do, that will cause the miscarriage of a healthy pregnancy. Most of my patients are desperate to find a reason, so that they can avoid that specific factor during a future pregnancy. However, most miscarriages are due to physical problems, including abnormalities in the chromosomal makeup of the fetus.  

You may have found this article through a search engine, but please don’t spend time on the internet trying to find a cause for your miscarriage. There is a lot of erroneous information online. If you need to find information beyond what your doctor is telling you, look at trustworthy sites like ASRM or ACOG.  

Partners experience a different kind of loss.

Another thing to remember is that the person carrying the pregnancy may well be coping differently than their partner. When you were pregnant, your body may have felt different, and your senses may have been altered. Additionally, your body experienced the actual physical consequences of the loss, whether on your own or after a D&E surgery.  

For your partner, this experience was entirely abstract. It is far harder to grieve something that might not have felt real. However, this doesn’t mean that your partner isn’t having a hard time too. Research shows that partners truly grieve, but may try to force themselves to not feel their pain to better support you. Understand that your partner may be feeling or coping differently from you, and that doesn’t mean that you are right, and they are wrong. You are both coping in a way that hopefully works best for you. 

Coping with your loss.

Following a pregnancy loss, planning the next steps on your fertility journey may feel very hard. You may feel overwhelmed and out of control of your body, your family, and your future. The feelings you are likely experiencing now should start to slowly decrease in their intensity over time. Be aware that getting pregnant again can cause some anxiety. This is entirely normal and appropriate and will likely subside once you pass the point in your pregnancy at which you previously experienced a loss.  

Moving forward after pregnancy loss 

• Start a daily relaxation habit, especially if you are experiencing symptoms of anxiety. 
• Consider a ritual to help you mark the loss. For example, planting a tree or bush in memory. 
• Identify family and friends who have experienced a loss and are available for support when you need it.  
• Reach out to the people who are helpful; avoid those who aren’t. 
• Recognize your need to self-nurture. This is a hard time and you deserve compassion. 
• Be aware that some people you share your loss with may not know how to respond, and might unthinkingly say things that come across as insensitive or even cruel. Think of polite responses and memorize them, so you aren’t caught off guard.   
• Establish boundaries that will work for you. 
• Remember not to blame yourself or anyone else. There is no thought, emotion, or behavior that will cause a healthy pregnancy to stop. 

As you go through this difficult time, please also remember that it is very likely you might conceive a healthy pregnancy soon. It’s normal to have questions about how this loss may affect your future family planning. Keep a running list of questions to ask your doctor, and see if your partner can attend your follow-up appointments (in person or virtually). 

Don’t be surprised if you feel envious of other people’s pregnancies or uncomfortable around babies during this period of time. This is entirely normal and happens to many women who have had a loss. If you continue to feel anxious and/or sad, seek out counseling from a mental health professional who is well versed in the psychological aspects of pregnancy loss, at ASRM.org.  

About Dr. Domar 

Alice D. Domar, Ph.D., is a pioneer in the field of mind/body medicine and a best-selling author. In addition to serving as Chief Compassion Officer for Inception Fertility, Dr. Domar is a part-time associate professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. She has help hundreds of aspiring parents through her practice as well as through her books, which include Finding Calm for the Expectant Mom.