October 15th is recognized provincially and internationally as Pregnancy and Infant Loss Awareness Day, and things are changing. Public recognition of pregnancy loss has increased, providing an opportunity for awareness to go deeper. Recovering from a miscarriage is difficult. New studies are showing the loss can have a lasting effect on mental health; many women experience symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression. While much progress has been made in regard to the stigma and false beliefs associated with these conditions it can still be hard for women to talk about their experience.  

 

Miscarriage combines two dreadful events: The ending of a wanted pregnancy and then the separation of that pregnancy from the mother’s body; an often traumatic personal experience. Isolation, silence, self-blame, unanswerable questions, and traumatic memories can follow women long after they leave the hospital.  Additional challenges such as infertility or recurrent pregnancy loss may also affect future pregnancy outcomes. Under this sadness, trauma, and stress it is easy to see how mental health symptoms can develop.                  

 

What can be harder to understand is the difference between distress from bereavement and distress from depression, anxiety, and PTSD. In the early weeks and months following pregnancy loss the characteristics of one can mimic the symptoms of the others. Cultural silence may prevent women from talking openly about ongoing mental health issues in the months following the loss. Differentiating grief from mental health symptoms can be challenging. It requires the time, patience, and the expertise of caring physicians, nurses and mental health professionals.  It requires greater public understanding so that partners, family, and friends can offer their invaluable support over longer periods of time.           

 

To lessen feelings of stigma and isolation women are often reassured by healthcare professionals, family and friends that pregnancy loss is very common (1 in 4 pregnancies); a “normal” part of human reproduction. Yet the actual experience of losing a wanted pregnancy can feel anything but common or normal. Should not the experience of loss, fear, pain, and lack of control be well within one’s ability to endure if, after all, it is a common outcome of pregnancy? Women may conceal or minimize mental health symptoms fearing that most “normal women” would be able to cope with this common outcome of pregnancy.      

 

Fortunately, views are evolving: contemporary research, writing, social media, and celebrity disclosure has led to a better discussion - and a more open and compassionate understanding - of both mental health and pregnancy loss. We are coming to accept that the brain and the body are simultaneously robust and vulnerable. Both systems are susceptible to stress, illness, and loss. Acknowledging the profound effect these experiences have on us is no longer seen as a sign of weakness or fragility; it is simply a sign of being human.      

                

We cannot erase memories nor avoid loss, but the complications incited by grief and trauma can be dealt with effectively. Like the body, the brain can heal.

 

Following early pregnancy loss women may find it useful to talk with a doctor, nurse, or counsellor about mental health symptoms and strategies for support and recovery. Women and their partners may find it useful to connect with other families who have experienced pregnancy loss.

 

Women are strong; we will endure.  But, like any one of us who has faced the unthinkable, we also need time and support to recover. We must reach out for help along way.

 

Shannon Golletz M.Sc.