Miscarriage Support

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• Pregnancy After Loss
• Miscarriage

Why miscarriage happens and how to cope

By Teresa Pitman

Pamela Mitchel has had two miscarriages as well as three full-term babies. “By the time 12 weeks rolled around, we had told pretty much everybody. Then the spotting started,” she recalls about her fourth pregnancy. “I went to an ultrasound, and the tech confirmed it. It was very hard. I was numb. I felt betrayed by my body.”

Jill Aharon already had two children when she conceived again, and her husband hadn’t wanted more. “My third pregnancy came as a delightful surprise to me, a shock to my husband. It was a difficult time for us,” she says. “When I began spotting, I blamed him. He created the stress, so he was responsible. The miscarriage itself was heartbreaking. It was a lonely and painful process. And sad.”

Unquestionably sad. Between one in six and one in five pregnancies ends in a miscarriage. The rates are higher for women past their 20s: for pregnant women over 40, the rate is about 40 percent. And whether or not the pregnancy was planned and desired, the experience can be emotionally difficult.

Saskatoon obstetrician Dr. Ahmed Ezzat, President of Obgyn, says for most couples, their first reaction is to blame themselves, and he stresses that this is a natural part of grieving. “Too often other people treat miscarriage as not a big deal, and will say things like ‘you’re young, you can have more.’ That’s not helpful. This is a real loss, and parents need to take the time they need to grieve.”

He adds that while parents often want to know why the pregnancy miscarried, in many cases there is no known cause. About half of all early miscarriages (before 12 weeks) are due to chromosomal abnormalities in the baby. Another significant percentage are caused by abnormalities in the baby that are not due to genetic problems.

“Sometimes the mother’s uterus is abnormal in shape or structure, and that can also cause a miscarriage,” says Ezzat. “Other causes include an acute infection that causes a high fever, and some chronic illnesses such as thyroid disease if these are not well-controlled.” Heavy smoking (more than 10 cigarettes daily) is also linked to miscarriage, as well as cocaine use.

Some women suspect early on that the pregnancy is not going to continue. Kate Vanderwielen says: “My miscarriage was a relief. I knew something was wrong, and when the doctor came in after my ultrasound and said the baby didn’t have a heartbeat, I had a huge sense of relief. I was sad that a life was not born, but to me it was nature’s way of taking care of something that wasn’t right. It was a hard time, but I have been at peace with it.”

While the physical side of recovering from a miscarriage is usually fairly straightforward (although some women do require a procedure called a D&C (dilation and curettage) to remove tissue that hasn’t passed on its own), the emotional side can be challenging. A recent study published in the British Journal of Psychiatry found that women who have had miscarriages can still feel depressed or anxious years later, even if they’ve had other children and feel they have "moved on." Finding a way to work through the feelings of sadness and, perhaps, anger can be challenging, and women take different routes to healing.

If you’ve had a miscarriage, here are some ideas that have helped other mothers deal with the emotional side.

1. Seek help from counsellors or spiritual leaders to help you gain perspective on your loss.

Aharon got help from “a very special spiritual leader who helped me understand and feel in my heart that my precious baby came as a gift, to help me and had done her important job. I believe that my baby lived just the length of time that she was meant to, and I was able to let go of anger and blame and came to be at peace. I am still sad not to have known my third child longer, but always grateful to have been blessed with her short life.”

2. Ask about local supports for parents who have had miscarriages.

Bereaved parents groups may sponsor groups specifically for those who have lost their children prenatally, or you may have a Perinatal Bereavement Services group in your community. These groups connect you with other parents who have been through a similar experience and who can understand what you are feeling.

3. Be prepared for the emotional impact of certain dates, and plan to take extra care of yourself on those days.

Many women find they are in tears as they approach the “due date” of the baby they lost, or what would have been baby’s first Christmas or their first Mother’s Day as a mother. Knowing that these days can be difficult, make a plan to have dinner out with supportive friends, to have a special evening with your partner, or other activities that will help you feel supported as you grieve.

4. Don’t feel that you need to minimize your loss.

Sometimes people will expect you to “get over it” quickly; you need to take whatever time you need to grieve the baby that wasn’t born.

5. Be a little creative and plan a way to let your baby go that is meaningful to you.

Linda Boissinot miscarried on her 22nd birthday, then went on to have two more babies. “I was just too busy with my sons to give my miscarriage much thought for years, but when my youngest was gradually weaning, it hit me like a ton of bricks,” she recalls. “While I had miscarried too early in the pregnancy to know the baby’s sex, I always thought it was a girl. I decided to name her, and I imagined her being baptized and decided to choose two godparents for her — a deceased family member and a deceased family friend. I turned her over to them for safekeeping and almost immediately stopped longing for her.”

6. Find something tangible that you can keep with you so you know the baby you lost is not forgotten.

Mitchel was helped by “a soft little while bear that came to me as a gift from a friend in Spain — the only gift I received during that pregnancy. This bear is named Kiko Nico and this is what is on his tag: 'Kiko Nico is different, he has one ear larger than the other, a very big head, and one of his arms has been mended. Although he’s not perfect, he’s happy because his friends are always by his side.'”

With a new baby to cuddle, Mitchel says she hasn’t needed to hold her Kiko Nico bear for a while, but she keeps him close by. “He represents my lost children, so I want him near me, as I would any child,” says Mitchel.