How to Find Your Truth After Pregnancy Loss

While writing our book All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss, my coauthor Kim Hooper and I discussed unexpected emotions that frequently (daily, hourly, constantly), erratically (feeling comes, goes, reemerges with a vengeance after a long absence), and, sometimes, incongruently (for example, anger when people are kind) surface following pregnancy loss. Kim experienced—and suffered—four losses, two of which were ectopic pregnancies, one at a later stage of gestation.

These emotions often first emerge in the healthcare setting. So you'd think providers would show sensitivity and allow space — or at least acknowledge to patients — of the rollercoaster waiting within. But recent research shows the opposite. According to a recent study in the Scandinavian Journal of Caring Sciences, "Parents who experience involuntary pregnancy loss encounter nurses and midwives when requiring care. But the environment in which this attention is provided turns it into a stressful and challenging event that favours the concealment of emotions."

Here are some of the thoughts and themes that we wanted to share for anyone in the midst of similar grief.

What did you not realize, perhaps, until you experienced it the first time? Did your experience change/deepen/widen with each?

My first loss was a complete shock to me. I’ve always been a Type A overachiever, always doing “the right thing.” I didn’t understand how anything could go wrong when I had done everything right. I’d also been pretty fortunate to not experience much personal tragedy, so I still had this youthful feeling of invincibility. I changed after that first loss and felt more vulnerable to tragedy. Over the course of my losses, I went from bitter, flabbergasted, and angry to more peaceful, calm. It really sank in for me that we have so little control over so many things, and I learned to find that liberating.

Though it may seem counterintuitive, feelings of ambivalence can surface during the grieving process. It can be confusing. What was your experience—and what would you like others to know?

The grieving process is so complex. I really wanted it to be linear. I wanted a checklist to follow. I was very often blindsided by the different feelings I experienced—one day, I’d be enraged about my losses; the next day, I’d feel a quiet acceptance. It’s very unsettling not knowing how you’re going to feel from one day to the next. Some women I spoke with said they also had ambivalence about the loss itself. Some felt a bit of relief, thinking maybe they weren’t ready for motherhood. That was often mixed with guilt. It can all be very confusing. There are so many waves in the grieving process and it’s an ongoing challenge to learn how to ride each of them. But that would be my advice—try to see them as just that, waves. Trust that if you feel awful today, that is not your forever feeling. There are ebbs and flows.

If you did not feel an instant connection to your baby, for whatever reason, you may feel guilty about your loss or unentitled to your sadness. What surprised you, in hindsight?

When writing the book, I talked to a few women who mentioned this. Some women do not plan a pregnancy and are ambivalent about being pregnant. Then they experience a loss and think, “it must be because I was unsure about becoming a mother.” And they assume they should just “get over it” because they weren’t as invested as they should have been. The reality is that these types of losses can really affect us in ways we do not expect. I went back and forth for years about whether or not I wanted to be a mother, and I thought my first loss was punishment for my uncertainty. The sadness I felt about losing the baby was compounded by that underlying guilt. There tend to be so many layers to the grief.

Believing that your body 'screwed up' is a way of assuming personal responsibility for your loss. It is also a way of contributing to the narrative that miscarriage is rare and within a person’s control. In this way, you’ve internalized an expectation that society places on you—an expectation to become a mother.

I always say that in these situations when there aren’t clear-cut answers and a solid reason for something happening, we turn on ourselves. It’s more comforting, in a twisted way, to think we are to blame than to accept that sometimes there is no fault, sometimes bad things just happen. Like you said, it’s about an exertion of control. I wanted to think it was something I did (or didn’t do) because that implied I could take my learnings and prevent a bad outcome the next time. But, of course, it doesn’t work like that. Pregnancy loss, like many things in life, is often random and does not have anything to do with what a person did or didn’t do.