Miscarriage after fertility treatment
The loss of your baby early in pregnancy can have a profound effect on you and your partner. Miscarriages are a reality in any fertility programme, although the use of assisted reproductive technology only slightly increases the chance of miscarriage. About 20% of pregnancies end in miscarriage, most often because of a genetic problem which stops the baby from developing normally.
At the time of the loss of your pregnancy you may simply be in a state of numbness and shock. The news may come completely ‘out of the blue’ at an ultrasound scan when you expected to see a beating heart. It may come when you are told about falling blood hormone levels or it may come after days of cramping, spotting and uncertainty.
Regardless, the confirmation that your pregnancy is over is likely to throw you into a state of shock and powerlessness. Often the shift from being pregnant to not being pregnant occurs within the space of 12-18 hours. The speed of this event contributes to your sense of unreality.
You may have miscarried at home, perhaps alone. This may well have been a frightening experience when you did not really know what was happening or what to do next.
Just because no child was born and just because I didn’t feel the life of that baby, doesn’t mean I didn’t love, lose or mourn its leaving. It was my baby - someone – even if I never saw the colour of hair or shape of face - a baby was there just the same.
The first days and weeks
Physically, it is likely that you will feel tired and have very little energy. Cramps may last a few days and you may bleed for up to 3 weeks. Your breasts may feel tender and uncomfortable.
You will experience many different emotions as a normal response to your pregnancy loss, but you may not have been expecting to have such intense feelings, and may feel worried that your reaction is not normal.
Everyone reacts differently to a miscarriage, but your own experience of grieving will be right for you.
There is no single predictable pattern which your feelings will take. Instead, you will move slowly and unevenly through a confusion of different emotions, eventually reaching a time when the memories of your baby and your miscarriage have become part of your life and the feelings are less painful.
Coping with grief
You may become very tearful and sad. Your body has to adjust to the loss of pregnancy hormones, and so you may feel that your moods swing erratically from calm to distress and back again. A chance remark, a song, or seeing a baby in a supermarket may make you feel sad, angry or resentful.
You may feel like retreating, staying at home, even in bed, and not exposing yourself to the stress of shops, work and the outside world. By experiencing a few days of stillness, without too many external demands, you can acknowledge the meaning of your loss to yourself and ‘make space’ for any feelings to emerge. It may not be easy to take such time from the demands of family or work.
You may find, especially if your days are busy, that you have trouble getting to sleep or that you wake up in the night, possibly crying or distressed. Often you have been dealing with the needs of everyone else in your life and the quiet time at night is the first opportunity you have had to acknowledge and notice your feelings.
If you can, take the opportunity of using this quiet time to help you absorb and adjust to what has happened. You may want to write down the story of your miscarriage, or to draw, or simply to sit quietly with a hot drink. For many women, this sleeplessness can be a distressing and lonely time. It helps to know that it is not likely to last more than a few weeks, at most.
You will probably find that these times of intense sadness and emptiness lessen with time, but that you still re-visit these intense feelings occasionally.
There are times and events which can make you feel especially vulnerable, including your next period, the due date of your baby’s birth, Mothers Day, Fathers Day, Christmas, the pregnancy of your best friend, the anniversary of your miscarriage, and if you choose to begin fertility treatment again. Being able to acknowledge these times in advance will help you understand your responses better.
Men and women often have differing reactions to miscarriage. A loss, particularly early in pregnancy, often has a greater impact on the woman who has been conscious of subtle body and mood changes. Men often say that they have not experienced a direct sense of loss, but are distressed and perhaps a bit bewildered by their partner’s reactions. Other men may find that they too feel loss and emptiness. They may have been the ‘strong’ partner dealing with hospitals, employers and family, and seldom receiving any acknowledgement of their own feelings.
You may be disappointed, hurt and angered by the reactions of your family, friends and workmates. They may seem to dismiss your miscarriage as unimportant and expect you to pull yourself together after a very short time. They may not even mention the miscarriage or refer to the baby. If you have had other miscarriages, they may assume you know how to deal with it all and that you should stop trying to have a baby. Sometimes you will be surprised and comforted by the caring reactions of others, and you will hear of other women’s miscarriages – even from years before.
If this miscarriage has been the latest of many pregnancy losses, or occurred after years of infertility and treatment, then your response to it may not be the same as the reaction of a woman who is younger or who has other children. This is not to minimise her loss. But you may be facing the loss of the possibility of ever becoming parents, and so the loss of your pregnancy will have a double significance for you.
Talking about fertility problems can help
One of the greatest ways to deal with infertility is to talk about it. This is not always easy or comfortable. At some point during infertility treatment, or investigation, you may experience a state of crisis.
This crisis in turn, may lead to feelings of isolation and despair. This can place a strain on your relationship. You may also feel alone and not have people to talk to who understand the experience of infertility. Due to the private nature of infertility, it is difficult to know who to contact.
All New Zealand fertility clinics have trained counsellors, and you do not need to be a patient of the clinic to make an appointment with a counsellor there. Fertility NZ exists to help you - call 0800 333 306 for guidance and support, or check out a group near you.