Surviving A Miscarriage — By Asherah Cinnamon, L.C.S.W.

Approximately 20-30% (depending on which statistics you look at) of all pregnancies end in spontaneous miscarriage and loss of the pregnancy. After the age of 40 that "jumps" statistically to 50% of pregnancies ending in loss, naturally and without human intervention, Indeed, often in spite of valiant efforts to fend off the possibility of a miscarriage. I knew these statistics when I became pregnant, yet I was emotionally and factually unprepared for what happened, and so was my partner.

Few people talk about death in our culture. Most feel it is best not mentioned, even when there has been one recently. Even less talked about is the loss of a child through miscarriage, abortion or death. Regardless of your religious or political or ethical beliefs, when a woman is pregnant she has feelings about that fact and so does her partner, her friends and her family. How they deal with these feeling can influence relationships for years to come. In some cases not talking about it or not knowing how to do so can lead to the breakup of a couple or to feelings of inadequacy, helplessness, or despair. In fact all these feelings are normal and natural whenever there is a major loss. The question is; how can you take a painful experience and turn it into an opportunity for closeness and growth?

The situation I (we) ended up with was a nightmare. My father-in-law had just come out of a 9 week hospital stay during which he had almost died. I was over 40 and pregnant with my first and much wanted child. My mother, suddenly and unexpectedly, was hospitalized with chest pains and proceeded to have a massive heart attack. Four days later my father went into a different hospital for previously scheduled and much needed major surgery. I spent a week between hospitals while my husband stayed behind to help his parents with his father's needs. When it looked as if everyone was probably going to make it, I went home. I had been very careful of myself physically through all of this. I did not allow myself to get too tired, and I made sure to eat well and often. I even managed to go to bed early most nights. My family was concerned for my pregnancy and insisted that I think of myself and the baby first. I was actually able to do so by telling myself that my relationship with both my parents was very good. They knew I loved them and thanks to a few years of (my own) therapy and hard work, we did not have lots of unfinished emotional business between us. I would be grief stricken if either of them died, but they had lived well and I knew I was doing all I could reasonably do to be supportive of them. I probably worried less that I might have otherwise, because I had the baby to consider and I knew, at least in my head, that worrying would not help anything.

It would have been very easy to resent my partner for not being there to "take care of me". Just as he could have been angry that I was away when he needed me. But we were able to talk about our feelings without blaming each other and this, when we are able to do it, has been the key to our closeness.

Four days later I got home. My husband was able to locate help for his parents so that he no longer needed to sleep at their house to care for his father in the night. He had been there for three weeks. He went to bed early, looking forward to his first full night's sleep. I stayed up, and at 11 P.M. I developed "gas" pains in my intestinal area. I had just completed my third month of pregnancy and was congratulating myself for making it over the hump. I was not bleeding or even spotting blood, so I assumed I had indigestion.

At 6 A.M. my husband came down to the living room and found me doubled over in pain. I had spent the night that way, not wanting to wake him after his recent stresses. At his gentle but insistent urging, I called my doctor, who sounded unworried because there had still been no sign of blood. But she immediately offered to meet me at her office to check the fetal heartbeat - for my sense of well being. I was glad I had chosen a doctor very carefully and with many questions in advance about her availability and methods.

On the way to the doctor's office we talked about our fears and tried to comfort and cheer each other. She was not able to find a heartbeat and as she was examining me I began to bleed. I cried hard, reassuring her that was what I needed to do if I was to get through this ordeal. I asked my husband to hold me while I cried, which was good for both of us.

The doctor offered me pain pills, which I said I would take if needed. But I knew that they would also dull the emotional hurt and then I would have to grieve even longer, so I waited and let the pain give me further permission to cry. Some doctors find it very difficult to see people in pain. Nearly all seem particularly unprepared for intense emotional pain. You should know your own needs in this regard and educate your doctor. If you tend to want to get rid of pain right away, try tolerating it just a bit longer than usual, not for the purpose of proving how tough you are, but to give your body and soul a chance to heal naturally (THAT IS THE FUNCTION OF TEARS). I had not been warned that I would go through all the stages of labor. I found myself doubled up on the office floor, suddenly nauseous, dizzy and unable to get up. I was in transitional labor. It lasted only a few minutes, after which we were told we could go to the hospital or home to complete the bleeding and cleaning out process. I chose home. Though my husband was worried and fearful for my safety, he left the choice to me. This was very important for both of us. At all stages he knew that it was my body this was happening to and he did not try to control what I did with it. On the other hand, he did not withdraw either; he let his preferences be known when asked, but he supported my decision making. I suspect that is what allowed me to stay in such good emotional contact with him even while in pain. I also knew that if at some point I did not feel up to making a decision I could ask him to do so and he would, without taking over more than I needed him to.

Wanting him to feel comfortable as possible about my choice to complete the miscarriage at home, I compromised and called a mutual friend who had had two children of her own and agreed to stay with us for the day. I had not known that she had also had a miscarriage. Now that I have had one, I find people telling me about theirs.

Having a loving, unworried friend help us through that day was wonderful. I did not want to be left alone and my husband was able to sleep for a few hours, which made him better able to give me tender attention later. I suspect that many couples try to handle miscarriages alone and after this experience I would strongly advise you to let your friends and family coddle you. Let your own needs and desires be your guide. You may not want many people around, but remember that your partner probably feels responsible for your well being and could use some emotional support too. Having a third person around can often diffuse any tension that can build if both of you are tired and sad.

A third or fourth adult can also help with other children in the family, giving them good attention and information, while they talk about their feelings and cry too. Contrary to folklore, children of ALL ages go through mourning. An expected new sibling is a potentially great loss to any child, even one too young to understand fully about the permanence of death. They will also need to know that their mother will be physically all right (if that is so) and that her physical and emotional state, as well as that of the father, will be up and down for a while.

For weeks after the miscarriage I was physically exhausted and did not want to spend much time in small talk or listening to other people (something required for my work). I took some time off and would take more if I had it to do again. I fought guilt feelings about having neither a child nor energy for work. I told friends and family that I was feeling this way and asked that they write rather than call (and not take it personally). Your needs may differ. The point is to make them known and remember that it may seem a bit unreal to you, but you have lost much and need time to grieve in your own way. Don't play hero or superperson. Everyone wins when you let the people who care about you, love you in just the way you need them to.

My husband and I found that a week after the miscarriage, when the crisis was over, our closeness gave way to a distance and even irritability. We talked about this too. On the whole we became closer to each other through our grief, and our relationship, having withstood a major storm.

May you remember to love and neither blame yourself nor another, grieve and not hide your grief, notice the wonderful things you still have in your life, and ask for assistance.

If you are concerned that you may not be healing emotionally from a loss as well as you should, or if the loss has hurt a relationship and you are not sure what you can do about it, there are social workers and other psychotherapists in clinics, hospitals, and private practice who can help. They can be found in the yellow pages under, "social service organizations", "marriage, family, and individual counselors", or "psychotherapists". Some organizations also have self-help support groups.