Emotions Surrounding Pregnancy Loss
Pregnancy loss, or fetal death, can happen at any stage of pregnancy. It is more likely to occur before 12 weeks, when it is referred to as miscarriage. After 20 weeks’ gestation, it is called a stillbirth. Stillbirths are rare, affecting fewer than one in a hundred pregnancies in the U.S.
Fetal loss can be caused by genetic problems like Down’s syndrome, maternal illness or physical difficulties with the uterus. In many cases, the cause remains unknown. Coping with pregnancy loss can be extremely challenging. Strong emotions, including grief, anger, guilt and fear are normal. Women and their partners manage in different ways, none of which is right or wrong.
Dr. Diana Carter of the University of British Columbia explains that pregnancy loss is a complicated psychological event. “Women who have experienced miscarriage often have common bereavement reactions and while the intensity and experience of these reactions diminishes over time for most women, a substantial minority will develop long-term psychiatric consequences,” she writes.
A team from New York State Psychiatric Institute interviewed 114 women at six to eight weeks after miscarriage. Their mean level of depressive symptoms was “substantially elevated” above that in the community. Twenty percent were “highly symptomatic,” as compared with 10 percent among community women.
Depressive symptoms were more likely for younger women and those with a prior pregnancy loss, but did not vary with number of living children, marital status, ethnicity or educational level.
Dr. Benjamin Hale of the University of Colorado says that after a pregnancy loss, women may feel a sense of responsibility or guilt for what happened. These feelings can lead to a host of unpleasant emotions that bereaved mothers and their partners carry for years.
Dr. Hale believes that the usual approaches, which seek to overcome the mother’s feelings of self-blame, “play down her emotion as somehow an irrational response to events outside her control.” But a mother who feels this sense of guilt has good reason to feel upset, even responsible for the life of the child, but not culpable for the unfortunate turn of events.