Women, their partners and families may experience a range of emotions after a pregnancy loss.Pregnancy loss affects individuals and families in complex physical, emotional and psychological ways, and it is often misunderstood.
Candace Knight, Ph.D., associate professor at the University of Alabama at Birmingham School of Nursing, discusses the different forms of pregnancy loss, common misconceptions, and how health care providers can offer support during and after loss.
Forms of pregnancy loss
Pregnancy loss is the loss of a pregnancy at any stage. A common form of pregnancy loss is miscarriage, which is the loss of a pregnancy up to 20 weeks’ gestation.
“Early pregnancy loss occurs most often during the first trimester, within the first 12 weeks of pregnancy,” Knight said.
Miscarriage typically occurs in the uterus, but some pregnancy losses develop differently. An ectopic pregnancy is when the embryo transplants outside of the uterus, often in the fallopian tube.
“This type of pregnancy loss can be life-threatening due to the risk of fallopian tube rupture and internal abdominal hemorrhage,” Knight said.
Pregnancy loss can potentially occur later. Stillbirth, also known as intrauterine fetal demise, is the death or loss of a fetus after 20 weeks’ gestation, in which the fetus is delivered with no signs of life.
Grief following pregnancy loss
Women may experience a wide range of emotional responses following a loss.
“Sadness and tears may come and go without a clear trigger,” Knight said. “Shock and confusion are common, especially when there were no prior signs of complications or when a person was unaware they were pregnant before the loss occurred.”
Women sometimes have feelings of numbness, anger or jealousy when seeing other pregnant women or babies after a loss. Guilt is another common emotional response, and the loss can lead to mental health concerns or worsen preexisting mental health conditions.
“Many women wonder if they did something to cause the loss,” Knight said. “Feelings of loneliness are common, particularly when others close to them have not experienced loss and may struggle to understand the depth of grief.”
Grief following pregnancy loss is often misunderstood. Support can be difficult to provide as some phrases seem to offer reassurance but may instead invalidate the grief.
“Statements such as ‘you can always try again’ often minimize the loss and fail to acknowledge the grief,” Knight said.
A common misconception is that grief is less intense following early pregnancy loss. The impact varies depending on specific circumstances. “Factors such as recurrent miscarriage, infertility or feelings of guilt can make an early loss just as devastating as a later one,” Knight said.
Knight says that, in some cases, women may feel relief following a pregnancy loss, particularly if the pregnancy was unplanned or undesired. “This causes feelings of shame, making it essential for providers to approach each scenario without making assumptions about how a woman should feel,” Knight said.
Fathers and partners in the grieving process
Fathers and partners may not experience the physical aspects of pregnancy loss, but the emotional impact can lead to mental health challenges such as anxiety or depression, according to Knight.
“Speaking directly to fathers and partners about their experience and feelings is important,” Knight said. “They may experience loss differently and may be less vocal about their grief.”
How to offer support
Grief counseling or participation in a support group can offer valuable coping tools. Being surrounded by others with shared experiences can be therapeutic, though some women may hesitate to seek support due to fears of not being understood.
While many individuals can navigate grief with time and support, there are situations in which immediate mental health care is necessary. Professional support is needed when symptoms like persistent negative thoughts about oneself, excessive worry, flashbacks related to the loss, panic attacks, difficulty sleeping or trouble concentrating are present.
Medical providers play a vital role in supporting individuals and families after pregnancy loss.
“Effective responses begin with approaching each patient with dignity and respect and without personal bias,” Knight said. “It may be comforting for women to hear that they are not alone, their feelings are valid, and they are truly being heard.”
Encouraging mental health grief support, helping women connect to supportive care or assisting with scheduling an appointment can be beneficial to reduce barriers to care.
In situations where a woman has thoughts of harming herself after pregnancy loss, Knight says to call 911, the Suicide and Crisis Lifeline at 988, or the National Maternal Mental Health Hotline at 833-852-6262.