It's shocking how little has been written about miscarriage, especially given how common it is. Several years ago when I was looking for books on miscarriage, I found only a few, and they were clinical; the "what went wrong" factor. I was looking for the "How do I deal with this?" aspect. Now there are a few hundred to choose from.
Miscarriage is often an unspoken loss; many couples choose not to announce a pregnancy until after the first trimester in order to avoid the risk of sharing the news only to have hope dashed. This can make for lonely beginnings of pregnancy -- for women and men.
Studies* show that loving care and emotional support are the best help after a miscarriage. Due to the silence surrounding miscarriage (and fertility issues), men and women alike may be deprived of the support of loving friends and family.
One to two percent of women have repeated miscarriages for unknown reasons. Fortunately, the chances of a pregnancy succeeding after multiple miscarriages is about the same as for a woman who has not had miscarriages. Maternal age and egg quality are much bigger factors.
But the stress of follow-up pregnancies is understandably higher, and the desire to not share the news often increases as well. Both of these factors may lead to less social support at a time it is needed more than ever.
Partners may also have differing opinions -- and needs -- regarding whom to tell, and when to announce a pregnancy. If and when a couple ultimately decides to seek interventions for fertility concerns, their desire to talk about it may diverge even further.
Added to all of this, sex often becomes about making a baby. Sex shifts to being based on a schedule of ovulation tests or doctor recommendations prior to IVF cycles. Sex may be completely put on hold for IVF.
What was once loving, lustful, playful, bonding, and maybe even spiritual for couples, becomes a chore. This in itself is a major grief. At first, having a lot of sex is a fun part of trying to have a baby. Over time, if having sex is just about procreation, it may eventually become a tremendous block between mates.
Many couples don't talk about this shift until it has blind-sided them onto opposing sides of a great divide, and intimacy suffers. Men get tired of performing on demand, and women get tired of the singular focus of making a baby. And both persist out of their desire to be parents.
Actually talking about the stresses and loss of spontaneity can help couples maintain and even grow their intimacy. In this case, when I say intimacy, I mean emotional closeness, bonding, and attachment.
It's very important to take good care of yourself and each other when dealing with miscarriage. Recognize your differing reactions and needs, and that her hormones are going through many changes. Miscarriage is a loss of a shared, imagined future. So do grieve, and also take breaks from your thoughts by exercising, going to movies, listening to music, doing fun things together that you used to do, and so on. Reach out for social support that may include online miscarriage support groups. Eat well, minimize alcohol consumption, and get a good night's sleep.
For those of you interested in statistics about miscarriage, here are a few:
- Most miscarriages are due to chromosomal abnormalities.
- Because women can take a pregnancy test so close to a late or missed period date, the miscarriage percentage rate is 30% or more.
- Without taking a pregnancy test, many of those eggs will miscarry without a woman even knowing she was ever pregnant; she will appear to have had a late period.
- 15-20% of natural implantation will end in miscarriage, mostly in the first trimester.
- The rate of miscarriage is much lower once the fetal heartbeat has been located (meaning the 10% to 15% discrepancy above may be implantation that did not grow properly).
* http://humrep.oxfordjournals.org/content/14/11/2868.long
