by Irv Leon, Ph.D. —

People who suffer miscarriages and stillbirths grieve over a baby they do not know. Understanding how these losses are different from other losses helps to appreciate the distinct way they are mourned. Here are several ways that pregnancy loss is unique.

1. It can feel less real.

When you grieve, you typically recall the beloved with longing memories —  his/her voice, face, treasured interactions.  With pregnancy loss, there are no such memories to grieve. There is silence and blankness instead.  This is why it is usually helpful after a stillbirth to see the baby you grew to love during your pregnancy, to get to know her or him as a real person, as a daughter or son).  Even if you are unable to (or choose not to) see, hold, and touch your baby, having pictures or mementoes can be another way of concretizing and identifying who was lost.

2.  Sometimes it’s losing a baby; sometimes it’s not. For many women and their partners miscarriage is a confusing, anxiety-provoking event.  Unlike a stillbirth, there usually is no body to see, and the pregnancy may not have gotten far enough along to be felt as a baby.  What was lost?  For some, it was a baby, especially if viewed earlier in ultrasound.  For others, it is felt as a blow to a woman’s maternal creativity.  Or perhaps it is a profound disappointment.  Sorting out what was lost can help determine the personal meanings of a miscarriage.

3.  It injures the self and self-esteem. More so for women than for men, pregnancy loss is an assault upon the self.  It feels as if your body has failed.  Reproducing has intimations of immortality.  It is becoming a co-creator with God.  For many women, depressed feelings following these losses may be as much a result of feeling terrible about oneself as missing one’s baby.  Finding other avenues of feeling proud of yourself may help to alleviate diminished self-worth.

4.  It revives other losses and hurts. Not uncommonly, we name our children after someone who has died, in his or her memory.  Conversely, when a baby dies, it may revive the intensity of a prior loss — a parent or some other important figure in one’s life. When grieving a pregnancy loss persists without relief for longer than a year, an earlier loss or trauma is often involved as well.

5.  It interferes with normal development. For many people, the goal of having children is not only to love the child but to gain the adult status of parenthood as well. Pregnancy loss often causes feelings of being left out and stagnating as one’s friends, siblings, co-workers are having children.  This often makes it intolerable to be around other pregnant women or families with babies.

6.  Others don’t understand. Many people don’t realize how profound a loss this can be.  Others may be uncomfortable with loss in general.  Even well-intentioned people say hurtful things–“You’ve been in the dumps for two weeks.  Get over it already!” “You can always have another baby.” “It was meant to be.”  Sometimes it may be useful to tell the offending person he may be well-meaning, but it doesn’t help to hear that.  If he or she is capable of listening, it may be possible to explain what the loss does mean to you.

7.  It is more difficult to end. Most losses entail grieving relationships rooted in the past.  Pregnancy loss almost entirely grieves what will be lost in the future.  So grief is intensified on particular anniversaries, especially the due date, or special holidays or experiences you hoped to share with your baby.  Even after the intense grief over pregnancy loss has subsided, there may always be events that trigger the everlasting loss of this baby.

Irv Leon is a psychologist who has worked for more than 20 years with reproductive loss, adoption, and bereavement. He is author of When a Baby Dies: Psychotherapy for Pregnancy and Newborn Loss (Yale University Press, 1990.) Reach him at irv.leon@prodigy.net.