Solitary Sadness: The Need to Grieve Miscarriage

By Wendy Ponte
Issue 113 July/August 2002

Ten years ago I stood in a temple in the Kamakura district of Tokyo, staring at hundreds upon hundreds of gray Buddha statues. Ranging in size from around 4 to 12 inches, they lined walkways, went up steps, and edged paths. Some were adorned with beads and flowers or wore little hand-knit caps; others had bibs with cartoons and white, ruffled baby hats. They stood silently amid the rock arrangements and soft bamboo trees. Their sheer numbers were breathtaking. Later I learned that this temple was a place specifically for women who had had pregnancy losses-some early, some late, even some whose losses where the result of intention to end a pregnancy.

It is only now, having experienced both successful childbirth and a recent miscarriage of my own, that I know how significant that temple is and how few places there are in our culture to really mourn the early loss of a pregnancy. Anyone who has gone through this experience knows what it means to mourn a dream, an infant that never was, yet was somehow already a part of you. Perhaps the hardest part is how rarely such loss is acknowledged by those around us, and how few miscarriage rituals exist.

Most people do not realize the depth of mourning that many women go through or understand how long recovery can take. "It turns out that the worst part was not the miscarriage itself, though that was pretty terrible," says Cathy Berger of Hoboken, New Jersey. "It is constantly being aware of where the pregnancy would be right now if it hadn't happened. I would have been just three months away from giving birth." Berger is lucky to have a supportive partner, Adriana Pacheco, who cares about her. "Sometimes, though, I talk it about it so much that I'm sure Adriana is thinking, 'When is this girl going to get over her obsession?'"

There is also very little understanding of exactly what causes miscarriages and what can be done to prevent them. Women tend to blame themselves for the loss when, in all probability, there was nothing they could have done to prevent it.

The veil of silence that our society casts over the topic of miscarriage makes it very hard for women and families to get the information and help they need when they go through this surprisingly common experience. "I think it's important for people to realize how devastating this can be emotionally, far more so than they ever would have imagined," says James Woods, director of Obstetrics and Fetal Medicine at the University of Rochester and author of Loss During Pregnancy or in the Newborn Period.

Although experts of all kinds, from midwives to grief counselors, agree that our culture is not very good at mourning this type of loss, many hospitals are still doing little to deal with women compassionately. "Oh, this happens all the time," is what parents are often told. Such words, and the medical practices that go along with them, clearly do not acknowledge how devastating the experience can be.

Supporting the Mourning Process
For most women, the first clue that miscarriage is poorly understood comes in the emergency room, or even in their own doctor's office. Medical personnel can be amazingly insensitive to women's feelings, according to Perry-Lynn Moffitt, coauthor of A Silent Sorrow. "They're very dismissive of this as an event worthy of grief. Doctors often say, 'Don't worry, you can get pregnant again,' without acknowledging that you were already attached to the baby." As soon as a woman becomes pregnant, Moffitt says, she starts to fantasize about how the expected baby will fit into the family and whether it's a boy or girl. To be dismissive of that compounds the grieving process. "If people know it's appropriate to grieve, they will express it and actually go through it more quickly."

Cecilia McGregor, of Minooka, Illinois, went to her local hospital when she began to spot at ten weeks. An ultrasound revealed that there was no longer a heartbeat. She and her husband then sat in a room for close to four hours, knowing the baby was not alive, waiting for a doctor to tell them what to do next. Finally McGregor was sent home and told to come back two days later for a scheduled D & C.

She returned, having carried her dead fetus for two days, and asked the hospital staff what would happen to the remains after the D & C. At first she could not get an answer. Several days and many phone calls later, she was told that the remains would be cremated and buried. Later, when she tried to find out where the fetus had been buried so that she could visit the site, her phone calls were not returned. Eventually McGregor found out that her baby had been disposed of in the hospital incinerator, along with medical waste. In addition to feeling largely ignored in the midst of the enormous grief she was experiencing, she had been given blatantly false information.

To help women work through mourning, Perry-Lynn Moffitt suggests trying to see the fetus, if possible. Without exception, every woman I spoke to who did see her baby after a miscarriage took tremendous comfort from the experience. "All those feelings about having a real baby are completely confirmed," notes Moffitt. A fetus is generally removed intact during a standard D & C, so there is no reason why a woman should not see it. Some doctors and nurses may balk at the request because they think it will be too painful, but, in fact, the opposite is true.