In planning this week’s blog entry, my first topical post for Maternity Matters, I thought long and hard about where to begin. There is so much to explore and so much that deserves attention in the world of perinatal mental health. After much reflection, I settled on writing a series about pregnancy loss.

Why? Because we don’t want to talk about!

Even though approximately 10-30% of clinically recognized pregnancies end in miscarriage (miscarriage refers to a pregnancy loss before 20 weeks) with miscarriage being the most common complication of pregnancy, we don’t talk openly about pregnancy loss.

Despite 1% of pregnancies resulting in stillbirth (pregnancy loss after 20 weeks), and many women being faced with the decision to terminate a pregnancy due to severe fetal abnormalities, if we speak about loss at all, its in whispers and hushed voices.

Given the statistics, chances are you or someone you know has lost a pregnancy, and yet we remain silent on loss.

Here’s the thing- not speaking about loss has real tangible consequences for women and families.

  1. When we are silent about loss people do not understand why and how it happens. As a result, many women hold themselves responsible (or are told they are responsible) for their loss. They believe their miscarriage was due to something they ate or drank. Or blame a stillbirth on a vigorous walk. In addition to their grief, those who have lost carry the enormous weight of guilt that is not theirs to shoulder.
  2. When we are silent about loss we don’t allow women and families to grieve. If we don’t acknowledge loss societally, we send the message that families should not mourn, and certainly not in a public or concretized way.We expect them to return to normal life in ways we would never expect of someone who had experienced a different type of loss.
  3. When we are silent about loss we don’t offer support to those in need or we don’t know how to. We say profoundly unhelpful or hurtful things such as, “it happened for a reason,” or “you’ll have more kids” or “at least it was early.”
  4. When we are silent about loss we are not careful about language. We say things to women like “why don’t you have another child” or “you waited an awfully long time to have children.” We don’t stop to consider how loss could be a factor in their family planning and how these “innocent” comments become daggers.
  5. When we are silent about loss we don’t recognize the physical impact of losing a pregnancy on a woman’s body. We don’t recognize the hormonal shifts they are experiencing, the physical pain they are in, or the sense of unease and disconnect a woman may experience within her body when she loses a pregnancy.

We are left with families who feel as though they are not allowed to grieve or don’t know how to mourn. Who are disconnected, isolated, and feel alone. Who do not know how to navigate other people’s ignorance. Who experience grief that is weighty, and compounded by guilt. This leaves women at risk for depression, anxiety, complicated grief, as well as at risk for developing a perinatal mood or anxiety disorder with a subsequent pregnancy.  This leaves women without resources, guidance, or support.

This is NOT ok.

The good news is we can bring pregnancy loss out of the darkness. The more we share stories, the more we talk about loss, the more we support families who have lost and connect people to the help they need, the more we help others heal.

Please stay tuned for more posts on loss over the next few weeks which will address ways to take care of yourself physically and emotionally after loss, how to support friends and loved ones who are grieving, and the impact of loss on relationships.

Disclaimer: For the purposes of this series of articles, I am grouping pregnancy loss (miscarriage, stillbirth, termination for medical reasons) together. While the experience and impact of these types of losses can differ greatly, these articles are meant to serve as an introduction to the topic of pregnancy loss with more specific, nuanced posts to follow.