The Unexpected Loss
|Published : Cosmopolitan Feb 2011
When excited mom-to-be Lily Allen had a miscarriage at six months last November, friends and fans rallied around as the devastated 25-year-old singer and her boyfriend of 18 months – decorator Sam Cooper – grieved. Yet, two years earlier, her miscarriage four months into an unplanned pregnancy drew a different response. Back then, Lily was single, having broken up with the father (Chemical Brother Ed Simons), and when she told the UK’s Daily Mirror that she was ‘in a very dark place after the whole thing happened’ and that it was ‘the toughest thing I’ve had to go through in my life’, some were surprised. General thinking is that having a miscarriage in circumstances such as these somehow makes it easier to handle – especially if it happens early in the pregnancy, when miscarriages are common. (It’s estimated that one in four known pregnancies ends in miscarriage – most in the first three months; many more are lost before women even realise they’re pregnant.) But miscarriage is a complicated kind of loss and can affect you whatever the circumstances and however early it occurs. According to Rochelle Friedman and Bonnie Gradstein, authors of Surviving Pregnancy Loss (Little Brown & Co), the psychological and physiological processes of pregnancy kick in soon after conception. Levels of reproductive hormones in your system soar, the lining of your uterus thickens to support the fetus, your breasts enlarge to prepare for feeding, and your emotions shift gear. An attachment and sense of ‘oneness’ with the fetus can form even when the pregnancy is unplanned, say Friedman and Gradstein. Unless you are set against having a baby (perhaps contemplating abortion or placing the child for adoption), you can be left feeling empty and incomplete when a miscarriage interrupts the pregnancy, grieving over what is lost now and for what may have been. ‘Coping with miscarriage may be one of the most difficult processes a woman ever has to face,’ says Illeana Cocotos, a Johannesburg psychologist and bereavement counsellor. ‘It can bring feelings of fear, sadness, depression and guilt, which are the normal emotions associated with grief. And with an unplanned pregnancy, many women may have resolved early feelings around not wanting the baby by the time the miscarriage occurs.
They may then experience the normal emotions associated with grief, as well as feeling that because they didn’t want the baby initially they somehow caused the miscarriage, or that it’s a punishment.’ Yet levels of grief can differ widely. ‘All loss follows the stages of denial, shock, bargaining, anger and depression, before acceptance begins and you can move on,’ says another Johannesburg psychologist, Dr Colinda Linde, author of Get The Balance Right (Metz Press). But the degree to which you experience these emotions will vary depending on certain factors, she says: was it a good-news pregnancy, the miscarriage of which was devastating, or was it experienced as a less significant loss? Was it an early miscarriage or one due to a severe genetic defect? Did it put stress on your relationship with your partner, or did it allow you to bond through shared grieving? Linde sees many young women in the early stages of commitment or their career who are either ambivalent about pregnancy or actively do not want children at that moment. ‘When they fall pregnant unexpectedly or because of pressure from their partners, a miscarriage can be an opportunity to assess where they are and what they want from their relationship and career at that stage,’ she says. ‘Of course there is grieving, as it is still a loss, but it is easier and they are able to move on faster.’ If you don’t want the baby at the time of the miscarriage, you may even experience a sense of relief when it happens, says Cocotos. ‘In this instance, a woman may rationalise that the miscarriage was for the best, and not experience it as a loss. She may recover easier and will not necessarily go through the grieving process; she can then experience guilt for not grieving, and see herself as an awful person for not feeling sad. Then again, some women still mourn after a miscarriage, even if they didn’t want the baby.’ The response to a miscarriage is so individual that most women would benefit from some type of counselling when it happens.
HOW BEST TO COPE
‘Counselling can help grieving mothers identify their feelings and reduce the risk of having emotional problems months or even years later,’ says Cocotos. (See ‘Time to get help!’)
1. Acknowledge your loss.
2. Feel your grief.
3. Invest in your relationship.
4. Adjust to your changed situation.
HELPING A FRIEND WHO MISCARRIED
Remember that the anniversary of the loss may reawaken her emotions – call or send a card, or take her a small remembrance.