Miscarriage and grief are both an event and subsequent process of grieving that develops in response to a miscarriage. Almost all those experiencing a miscarriage experience grief. This event is often considered to be identical to the death of a child and has been described as traumatic. "Devastation" is another descriptor of miscarriage. Grief is a profound, intensely personal sadness stemming from irreplaceable loss, often associated with sorrow, heartache, anguish, and heartbreak. Sadness is an emotion along with grief, on the other hand, is a response to the loss of the bond or affection was formed and is a process rather than one single emotional response. Grief is not equivalent to depression. Grief also has physical, cognitive, behavioral, social, cultural, and philosophical dimensions. Bereavement and mourning refer to the ongoing state of loss, and grief is the reaction to that loss. Emotional responses may be bitterness, anxiety, anger, surprise, fear, and disgust and blaming others; these responses may persist for months. Self-esteem can be diminished as another response to miscarriage. Not only does miscarriage tend to be a traumatic event, women describe their treatment afterwards to be worse than the miscarriage itself. A miscarriage can often be "heart-breaking". A miscarriage can affect the women, husband, partner, siblings, grandparents, the whole family system and friends. Almost all those experiencing a miscarriage go through a grieving process. Serious emotional impact is usually experienced immediately after the miscarriage. Some may go through the same loss when an ectopic pregnancy is terminated. In some, the realization of the loss can take weeks. Providing family support to those experiencing the loss can be challenging because some find comfort in talking about the miscarriage while others may find the event painful to discuss. The father of the baby can have the same sense of loss. Expressing feelings of grief and loss can sometimes be harder for men. Some women are able to begin planning their next pregnancy after a few weeks of having the miscarriage. For others, planning another pregnancy can be difficult. Organizations exist that provide information and counselling to help those who have had a miscarriage. Some women have a higher risk of developing prolonged grief and complicated grief than others. A factor that can affect grief for men is finding help in an environment that is traditionally women-focused for maternity care and support.
Psychological impact
Miscarriage has an emotional effect and can also lead to psychological disorders. One discorder that can develop is primary maternal preoccupation. This is defined as a " ...'special psychiatric condition' in which the pregnant woman identifies with her baby, highlights the crisis a woman faces when the baby with whom she is preoccupied and identified dies..." Grieving manifests itself differently for each woman after miscarriage. It may often go unrecognized. The grief that follows a miscarriage resembles, but is not the same as, the grief experienced after the loss of a family member. Disbelief, depression, anger, and yearning, are described as being a part of the normal grieving process. These reactions remain from three to nine months after the loss. Forty-one percent of parents experience a normal, expected decline in grief in the first two years while 59% were delayed in the resolution of their grief. Grieving can create feelings of loneliness. This grieving has been called a type of psychological trauma. Other serious consequences can develop including depression, anxiety disorder, post-traumatic stress disorder, and somatoform disorder. These responses all are associated with grieving after a miscarriage. Some women are able to complete the grieving process a few weeks after the miscarriage and start anticipating their next pregnancy. Planning another pregnancy is traumatic for others. The impact of a miscarriage can be "crippling" psychologically. Anger can be directed toward those who have had successful pregnancies and children. A woman can grieve the "loss of a future child" and question her own role as a mother. They may blame themselves or their partner for the miscarriage. Unsuccessful attempts to become pregnant through in vitro fertilization (IVF) can also elicit a similar grief response in women. Those experiencing a late miscarriage may have more significant distress compared to those who have experienced a miscarriage in the first trimester. Even depression can occur. "Women today...are aught in a unique historical moment: technology encourages them to form emotional attachments to their pregnancies, but society has not developed traditions to cushion the shock when those attachments are shattered." Descriptions of the miscarriage are expressed in non-clinical terms by those who have experienced the event.
Angry Cheated Despair Devastating Drowning Envy Guilty Lack of acknowledgement Not socially acceptable Numbness Pregnancy loss Shame Shocked Sorrow Stunned
Trauma Miscarriage has been found to be a traumatic event and a major loss for women. Pregnancy loss, including induced abortion is a risk factor for mental illness. The impact of miscarriage can be underestimated. The trauma can be compounded if the miscarriage was accompanied by visible and relatively large amounts of blood loss. Counseling can be offered but effective interventions to assist in recovery have been difficult to identify due to the reports of efficacy and ineffective counseling. Comparisons are hard to make. Despite the lack of studies that describe effective interventions for those with grief after a miscarriage, some clinicians still offer counselling and follow-up to help women recover and adapt to the loss. Recommendations to help recover from the event include:
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