Registered Marriage + Family Therapist
The Landscape of Grief: Understanding the Early Weeks and Months Following a Miscarriage
By Shannon Golletz M.Sc.
CROSSING THE THRESHOLD
You feel nauseous, tired. Your period is late, so you take the test, hovering over the stick for two minutes with bated breath. Your jaw drops when you see the two lines. This. Is. Happening. There are hugs, kisses, plans, dreams. Abundance. This is your new life!
Then, one day, there is blood.
You feel desperate. Confused. You look up miscarriage symptoms. No. No. No. Please, no. More blood. It hurts. This. Is. Not. Happening. There are calls, tests, tears. Cold jelly. Results. Sobs. More Blood. It’s over. No. It’s over. Condolences. Emptiness. Due date? Vacant. Body? Bleeding. Mind? Shattered. Spirit? In pieces.
This is your new life. Your miscarriage has brought you across the threshold that divides it into before and after. It’s a door you walk through and don’t get to exit. The territory beyond is dark and treacherous: Pregnancies end here; life stops growing. No one wants to be in this dark, murky place. But you are. And while you will never go back through the door, the landscape of grief will change as you walk it, the contours beneath your feet getting more familiar and easier to navigate. You will get stronger. You will endure. One day the landscape will look different; brighter. But we all start in the dark.
It is hard to think of a more bleak and painful time then the early days and weeks following your pregnancy loss. First tentative steps through this new territory of loss may be some of the most raw and heartbreaking moments of your life. There may be a sense of futile desperation to bring the pregnancy back to life; to erase, correct, and rebuild the structures your ultrasound marked as “abnormalities”; to go back in time to the day you saw a beating heart; to race ahead into the future when your next pregnancy will be thriving. You may feel empty, and desperately miss some of the pregnancy symptoms you were experiencing; as unpleasant as sore breasts and vomiting around the clock may have been, these were also clear and undeniable signs of life.
Passing the physical remains of a pregnancy can be difficult and isolating. While a birth is attended by a partner, nurses, midwife or doctor, miscarriage is often a solo act. Behind the door of your bathroom blood and tissues are passed. Sanitary pads and kitchen strainers catch what was once your future. And then another painful reality: We must flush. An unspeakable ending, but for early losses what choice do you have? There is no formal death system, no certificates, no funerals. It is simply a moment between mother (and perhaps partner) and her pregnancy.
Days and weeks pass. A cycle or two pass. You have come to see that this new place is quite different. The anticipation of a new baby has everything to do with life, growth, and dreams for the future. By complete contrast, death is halting and final, it shatters dreams and breaks hearts. While joy can feel effortless; grieving is hard if not near soul-crushing work. It requires physical, emotional, and spiritual endurance, because it can be relentless: It does not let up on Monday morning when you have to return to work and it most certainly does not take breaks on weekends and holidays. In truth, grief intensifies at celebratory times of the year because we are so painfully aware of who is missing and what we have lost.
The path you are walking will take you through canyons, mountains, deserts and oceans. Learning to navigate and survive means embracing vulnerability and unpredictability. In all aspects of nature, including the first weeks and months of pregnancy, there is a thin line between life and death. Tiny hearts stop beating and microscopic cells stop dividing. Your world can change on a breeze. This is the heartbreaking reality that now surrounds you.
LOST AND FOUND
During the weeks and months of your pregnancy you thought of yourself as a “mom”; you may have begun to see your partner as a parent, too. In the aftermath of pregnancy loss it is painful and confusing to know what identities to claim and carry forward.
This is especially true for first pregnancy loss (where there are no older children in the family). A woman’s identity as a mother has been shattered by the loss of the pregnancy. For many women, following primary loss, there is no reversal back to the identity of a single woman. The identity shift to that of “mother” remains rooted despite the loss of the pregnancy. Women may carry a new identity of “mother without her child”.
After primary pregnancy loss a woman leaves the hospital or ultrasound clinic passing proud parents carrying babes home for the first time or passing expectant moms attending their ultrasound appointments. She winces in sorrow; she looks the other way; her eyes well with tears. She may have a sense that she has just been cruelly kicked out of the circle; her membership to parenthood revoked. But on top of that she is asked to sit on the edge of a community and watch those around her. She may or may not know women in her life who have also been forced to the margins. The identity of “mother without her child” is shared by women who have missing children; who have children placed in adoptive homes; and who have lost children to stillbirth or death. She is not alone; but hers is an unenviable circle that shares collective feelings of invisibility and isolation.
For mothers with older children pregnancy loss can also bring distress associated with identity. Many women dearly hold a dream of family size; how many children she and her partner see “completing” their family. Commonly moms may also have a certain plan about the spacing of years between siblings or hopes for gender patterns. The loss of a pregnancy can interrupt or threaten the dreams she carried for that particular pregnancy as well as for her future hopes for family planning. Recurrent loss can almost entirely decimate a family’s plans for both number and spacing of children in the family.
Crossing the threshold into the land of loss is a protested and involuntary transition. It was not your choice to be here. Learning to live, and in time thrive in this new territory will be a great challenge, and you will find your way. For now, just getting through one day and then getting through the next is both a quiet and profound act of courage. The first steps are the hardest.
No one ever told me that grief felt so like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. At other times it feels like being mildly drunk, or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says. Or perhaps, hard to want to take it in. It is so uninteresting. Yet I want the others to be about me. I dread the moments when the house is empty. If only they would talk to one another and not to me . . .
An odd by-product of my loss is that I’m afraid of being an embarrassment to everyone I meet. At work, at the club, in the street, I see people, as they approach me, trying to make up their minds whether they’ll ‘say something about it’ or not. I hate it if they do, and if they don’t . . . And grief still feels like fear. Perhaps more strictly, like suspense. Or like waiting; just hanging about waiting for something to happen. It gives life a permanently provisional feeling. It doesn’t seem worth starting anything. I can’t settle down. I yawn, I fidget, I smoke too much. Up till this I always had too little time. Now there is nothing but time. Almost pure time, empty successiveness . . .
C. S. Lewis,
from A Grief Observed