October is miscarriage and infant loss awareness month
The latest statistics estimate that approximately 1 in 4 women and their families will experience a miscarriage. These statistics are high particularly considering that miscarriage and infant loss continues to be a topic that many people have difficulty talking about.
What is a Miscarriage and infant loss?
A miscarriage generally means the loss of a baby before the 20 week gestation period. There can be an early miscarriage which occurs in the first trimester of pregnancy (up to 12 weeks gestation) or a late miscarriage which occurs in the second trimester of pregnancy (12 to 20). If the death of a baby occurs after the 20 week gestation period it is then considered to be a stillbirth or loss of an infant.
What can cause a miscarriage?
There are several types of miscarriage including ectopic pregnancy where the pregnancy occurs outside of the uterus, a molar pregnancy where the foetus fails to develop after conception and a blighted ovum where the sac develops but the embryo is absorbed in to the uterus in the very early stages of pregnancy.
There is a common misconception that many women face that a miscarriage was caused by something that they did or did not do during the early stages of pregnancy. In almost all cases there is no maternal cause of miscarriage. Studies have failed to find a link between exercising, stress or sexual activity causing miscarriage. Many times women may not find out what caused their miscarriage however it is often because the baby did not develop properly due to a spontaneous and non-inherited chromosomal abnormality.
An important factor in miscarriage information is that in many cases women will go on to conceive and have a successful pregnancy after miscarriage. If you have a miscarriage that does not usual mean that you chances of miscarrying again will be higher than the 1 in 4 miscarriage rate.
What can cause infant loss?
Stillbirth or infant loss happens less frequently in Australia currently than it did in the past. However, statistics still indicate that 1 in 120 births will be a stillbirth or newborn death. A newborn death occurs within the first 28 days of life.
There are many factors that can contribute to stillbirth or newborn death. These can include congenital abnormalities, premature birth, problems with the placenta or cord, foetal growth restriction and complex maternal medical conditions.
Grief after the loss of pregnancy or infant
Grief or bereavement is a complex human experience which takes many forms. Although there are 5 stages of grief outlined below these do not always occur exactly as reported nor do they occur in a linear way or in order. You can also spiral through these stages moving back and forth between different emotions.
Denial and Isolation
Often the first reaction to hearing the news that a miscarriage has occurred or that a infant has died will result in feelings of denial. Often times we think to ourselves that ‘this can’t be happening’. This is a defence mechanism that our brains have developed to buffer the immediate shock of loss. This is usually a temporary response that occurs in the initial stages of grief.
As the reality of the situation begins to set in and the denial begins to dissipate we are often left with a very intense and raw emotion stemming from the pain of our loss. This is usually expressed as anger. The anger can be focused on a range of things including ourselves and others. Sometimes people find themselves blaming things, themselves or others as they try to find a way to make sense of their loss.
After we have experienced anger and then begun to feel more complex emotions such as helplessness and vulnerability we may look for a way to regain control this may occur through bargaining. During this stage parents will often direct this bargaining at themselves with thoughts or expressions such as “if only I had of been more careful” or “if I only we had gone to the doctor sooner”. Bargaining in the event of miscarriage or infant loss can be unhelpful as it serves to create further blame towards ourselves.
There are generally two types of depression that are associated with mourning loss. The first is a reaction to the practical implications of the loss. The thought of going through any burial or ceremonies being held and worry about what effect our grief has had on ourselves and those around us. The second form of depression experienced in the grief cycle is grief directly related to our loss, beginning to understand the implications of losing a pregnancy or infant and the lasting effect this will have on ourselves and families.
Acceptance is usually considered the final stage of grief. During the acceptance stage, some are able to find peace with the loss of their pregnancy or baby. During acceptance, we generally reflect on the events however with a calmer and more rational view and feel more confident in our ability to continue on after the loss.
The impact of grief for those who experience miscarriage and/or infant loss is significant and in some ways different from other experiences of grief. Pregnancy is often a time of hope, excitement and planning for the future. Many parents begin to plan changes to their lives and picture their future changing in the wake of the new they are having a child. When a miscarriage or death or an infant occurs these hopes and dreams are often shattered. Not only is their adjustment to the miscarriage of loss of an infant but sometimes also to plans for the future. Often time items bought in preparation for the baby serve as a sad reminder of the loss. Miscarriage and infant loss is also a particularly isolating experience. Sometimes parents have not told many people about their pregnancy and so they feel unable to communicate their loss. It may feel as though others don’t understand their loss due to personal nature of miscarriage or infant loss.
Connecting with others who have experienced a similar loss, accessing a specific service dedicated to miscarriage or infant loss such as programs through Among The Angels including speaking with a Counsellor are all ways of accessing support during this difficult time.