Emotional and Social Impact of Miscarriage on Women

Introduction: The Reality of Pregnancy Loss

The impact of a miscarriage can be profound, largely because the reality of death before birth tends to be an affront to society's beliefs and expectations regarding the cycle of life (Kader). Moreover, family, friends, and society in general tend to minimize its personal significance and emotional relevance to the woman or couple going through the experience (Kader). All too often, the impact of the experience is misunderstood.

A miscarriage is such a physical and emotional experience for women and couples that it is generally referred to as an "ordeal" or "nightmare" (Kader). According to Sharon Kader of the Infertility Awareness Association of Canada, this experience can be particularly difficult for couples who experience pregnancy loss after fertility treatments. Couples are constantly confronted by feelings of despair, self-blame, guilt, depression, shame, and anger over their unrealized dream, resulting in an experience similar to an emotional roller-coaster ride — "with despair, turning to hope mingled with fear at each intervention and then back to despair with each pregnancy loss or normal menstruation" (Kader). Their strength and perseverance to cope with such an emotional state while continuing their efforts at fertility intervention "is a testimonial to their bravery, courage and love of family" (Kader).

Defining Miscarriage and Who It Affects

Miscarriage, or unintended pregnancy loss — referred to medically as spontaneous abortion — usually occurs within the first twenty weeks of gestation (Kader). Although the miscarriage rate is roughly one in five pregnancies up to twenty weeks' gestation, the majority of early pregnancy losses occur within the first twelve weeks of pregnancy (Kader). Miscarriage after the first trimester does occur; however, it is less common (Kader). Kader points out that it is difficult to obtain accurate reporting of early pregnancy loss because a miscarriage can occur as early as the first six to eight weeks of pregnancy, before the mother even realizes she is pregnant.

Even if a miscarriage occurs just days after a positive pregnancy test, the reaction can include a wide spectrum of emotions. Although a woman and/or couple are mourning a baby that was never born, the daydreams about the baby and what kind of parents they would be were already well under way (Goff). This broken bond needs to be mourned, says Mary King, a licensed clinical social worker: "It is a loss... It may not be the same as someone you already knew, but it is the loss of a living thing" (Goff). It is especially difficult because no one expects to have a miscarriage, and if the couple has been trying to conceive, they go from happiness to being blindsided with bad news (Goff). Even with today's medical technology, at least half of all miscarriages — especially those that occur during the first trimester — remain a mystery (Goff).

Emotional Responses and the Shroud of Silence

When a woman experiences a miscarriage, she also experiences a reproductive crisis, and whether she is a single parent or in a partnership, the experience is one of unspeakable loss (Kader). There is usually a shroud of silence surrounding this loss because family and friends typically become uncomfortable when someone they love is in emotional pain, and they simply do not know what to say or do (Kader). Most people are at a loss as to how to comfort the woman and/or couple who have experienced a miscarriage, and this situation produces feelings of powerlessness for everyone involved (Kader). Not only are there feelings of great sadness for a life unlived, but often the woman and/or couple also carry feelings of shame and embarrassment that may prevent them from telling friends and family, thus leading to self-imposed isolation (Kader).

Most people do not understand the depth of mourning that many women and couples go through, or how long recovery may take (Ponte). For some women, it is not only the experience of the miscarriage itself that is difficult, but being constantly aware of where the pregnancy would be "right now" if the miscarriage had not happened (Ponte). Moreover, there is very little understanding of exactly what causes miscarriages and how they can be prevented, yet women very often tend to blame themselves for the loss (Ponte). The veil of silence that society casts over the topic makes it much harder for women and families to get the information and help they need when they go through this common experience (Ponte). Experts, from midwives to grief counselors, agree that today's culture is not well equipped at mourning this type of loss, and most hospitals still do little to deal with women compassionately (Ponte).