How to Recover From a Miscarriage

My wife and I experienced eight miscarriages before my daughter was born, and went through a range of emotions with each one. The losses understandably affected my wife more strongly—for me, they were a loss of a dream or hope, but for her, they were also traumatic physical experiences. Over the years, I’ve met numerous women and couples in my practice who come in because they, too, are emotionally trying to come to terms with a miscarriage. Here is some of what I’ve seen, heard, and learned:

You’re grieving.

This is to be expected and normal: You are experiencing the loss of a child, both the physical child and the imagined one, and also the loss of a vision, a dream of being a parent. Grief follows its own process, yet paradoxically, it is also unique to everyone. It brings that mix of sadness and anger; it often moves at its own pace. And if you have other unresolved losses from your past, they can reignite, adding to your emotional load.

You’re hypervigilant.

When we experience something unexpected—a panic attack that comes out of nowhere or a car accident—we naturally become hypervigilant after. Because there was no preparation and it seemed to happen suddenly, your brain responds by being hyperalert—looking around corners to be prepared for the same thing unexpectedly happening again. A miscarriage is no different: If you’ve decided to try again, you’re understandably looking for any signs of problems—cramping, unusual morning sickness—or, more likely, feeling vulnerable, alert to other unexpected problems showing up in your life that you can’t control.

You struggle with guilt, blame, and making sense.

Another understandable outcome: I should have [fill in the blank]. If hypervigilance is worrying about what might happen again in the future, the guilt and blame are about making sense of what happened in the past. Your mind will naturally spin and look for something as soon as you ask the question—why?

And as with any grief reaction, your thoughts, like a centrifuge, are swirling about, trying to sort out and distill what occurred to eventually land on a story that makes sense. Unfortunately, guilt and blame often get mixed into the story—I should have taken the pregnancy test sooner, not had that glass of wine at that wedding, not been so stressed at work: on and on it goes.

You obsess.

The swirling thoughts are obsessing about the past, but your hypervigilance may propel you into the future: obsessing about what you need differently next time—see a different doctor, confirm your pregnancy earlier, take time off from work, change your diet, try IVF. On the heels of the trauma and loss, you’re scrambling to find ways not to recreate the past again.

You’re depressed.

Depression is part of grief, but if it lingers, it’s different from grief. A lingering depression may be tied to hormones, but if you already have a history of depression or severe self-criticism, your thought revolves around a sense of despair, a why-bother state of mind, and a giving up.

Existential issues: If not a parent, who?

If being a parent and having your own child was up in the top three of your life goals, you now have to deal with not only the loss but the possibly the existential issues. What am I if I can’t be a parent? This, too, is another loss—a loss of your image of yourself and your future, but also your sense of purpose. Some are able, after some recovery, to try again or throw themselves back into their work, but others feel drifting—if not this, what’s next?

Again, all this is normal; it is part of coming to terms with a loss on many levels. Here are some suggestions on how to move through this grief:

Push back against the guilt and blame.

It’s natural, but it isn’t good for you; it can erode your overall feeling of competence and your self-esteem. You could hold this over your head as your ultimate failure—but don’t.

Support each other.

Under stresses like this, some couples naturally come together and support each other, but for some, it widens the cracks already in their relationship—you’re over-reacting vs. you don’t care—or they pull apart, each dealing with the loss in their own silos. You need to work hard against this. Reach out and be a team, even if you don’t feel like it.

Get medical information.

Your head is going to come up with all kinds of crazy theories about why and what to do next. And if you go online, you’ll probably find stuff that will make it all worse. Time to stay in reality.

Be assertive and ask your questions to find out about what happened and what to do next. If you need more information, ask for it. If you worry your physician is not as skilled as you need, get a second opinion. But that said, be careful you don’t go down the rabbit hole of finding the perfect doctor.

Decide on your bottom lines.

This is often a complicated couple decision, but you start by starting with yourself. At what point do you stop trying to get pregnant, start or stop IVF, decide it’s time to give up, or consider other options like adoption, foster care, or something else. This is hard stuff, but knowing your bottom lines actually gives you a sense of control in a mostly uncontrollable situation. The bigger challenge is that you and your partner get on the same page.

Get outside help.

These are always difficult decisions, difficult feelings to work through, and difficult conversations to have with your partner. If you need support, even a few sessions of individual or couple therapy may help you move forward.