Talking about miscarriage: a therapist’s perspective

Can discussing miscarriage publicly help to break taboos? (Image courtesy of Salvatore Vuono/ FreeDigitalPhotos.net)

The response to Facebook CEO’s Mark Zuckerberg’s announcement that he and his wife are to have a baby girl – after three miscarriages – has been astounding. Not only is someone talking openly and publicly about miscarriage – but that someone is a man, a famous man. To start a discussion about miscarriage, says Zuckerberg: “Brings us together. It creates understanding and tolerance, and it gives us hope.” The alternative – not talking about miscarriage at all – leaves couples struggling in silence. “Most people don’t discuss miscarriages because you worry your problems will distance you or reflect upon you – as if you’re defective or did something to cause this. So you struggle on your own,” adds Zuckerberg.

The fact someone so well-known has come out and spoken about his losses has already sparked debate about how hidden the topic of miscarriage is – and why it shouldn’t remain a taboo any longer. While an estimated one in five pregnancies will end in miscarriage, couples who have lost their baby during early to mid pregnancy rarely talk about it. The rule is that no one announces a pregnancy until the crucial 12-week scan, and so many early miscarriages are never known, revealed or discussed.

Zuckerberg is right when he says that discussing the topic can “distance you or reflect upon you – as if you’re defective or have done something to cause it”. As a counsellor working with women – and men – affected by miscarriage, a core theme to their loss is that other people really don’t want to know. They may show empathy at the start, when they discover the news, but will often feel awkward about it. The person who has miscarried frequently finds herself taking care of the feelings of others around her, because pregnancy loss is a difficult concept to understand or accept.

The tacit expectation is often that the couple are meant to “get over it” quickly because it “wasn’t an actual baby anyway”. Yet that little bundle of cells that became an embryo and started bringing symptoms of morning sickness – and then suddenly lost its heartbeat – contained the hopes and dreams of a couple planning for a real, live, actual human being to become part of their lives.

Therapists like me hear the stories of dozens of people affected by miscarriage, often because no one else around them (friends and sometimes family) wants to listen. Miscarriage is one of my specialist areas as a counsellor and psychotherapist. What I’ve learned is that ‘the world’ doesn’t/can’t/won’t understand that a miscarriage is a major loss and requires a process of grieving in order to come to terms with it. Within that process can emerge feelings of self-blame, guilt, sadness, shame, rage, self-doubt, anxiety, depression. Multiple miscarriages can understandably bring despair and loss of trust, hope and optimism. There can be lots of ‘What if?’ and ‘Why me?’ questions as the couples struggle to come to terms with what has happened, while feeling perplexed at the unfairness of it all – and question where to go to next. Even trying for another baby has its levels of angst and anxiety: what if it happens again? Even women who go on to have a healthy pregnancy next time round may be at risk of postnatal depression. There may be a new baby, but he or she will never, ever replace the baby that was lost – and there can be ambivalent and painful feelings to process around that, too.

Much of the comment around Zuckerberg’s announcement has focused on the need for men to receive more support, because they’re grieving a miscarriage too. Very often the man has to be ‘the strong one’ to support his partner through the physical and emotional impact of pregnancy loss. And, again, friends and family often don’t take the father’s feelings into consideration. I agree that men need time and space and support to come to terms with their grief, too. and I’ve linked to some of the responses to men and miscarriage here:

I’ve also included some links to articles that help sort out fact from fiction regarding miscarriage – especially around blame and responsibility:

In summary, I am hugely supportive of ways to bring miscarriage out into the open rather than keep it in the shadows. I applaud Mark Zuckerberg for being so honest and clear about what he and his wife have been through. I wish them both well, and I hope his considerable influence – by going public – has an effect on those tiny, daily interactions that people who’ve miscarried have had to hide, deny or avoid. Time to bring talk about miscarriage into the open.