Why Do Women Blame Themselves After Miscarriage?

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Whenever I talk to a woman who is grieving after a miscarriage, she will inevitably, at some point in telling me her story, blame herself. She’ll either attribute her pregnancy ending early entirely to a perceived ‘wrongdoing’ on her part, or throw guilt about something of her making into an already painful mix of feelings. I’m no longer surprised when I hear this, nor do I see the phenomenon going away anytime soon.

Despite miscarriage continuing to be the most common adverse outcome of any pregnancy — affecting an estimated one in four pregancies¹ — it is most likely to happen without an expectant parent knowing why. In the relatively rare case of investigations being made (in the UK this would happen after three consecutive miscarriages), these mostly yield inconclusive results. As it is in general, when we are faced with not knowing the meaning to difficult events that life can throw at us, we tend to make one up, which may include routing one back onto ourselves. This is an often unconscious effort to fill an unbearable gap, and allows for some sense of control. Joan Didion explores the ability to think 'magically' in her extraordinary memoir about the death of her husband: The lengths our minds can go to in order to make sense of grief can be huge. And this psychological trick will be at play when it comes to the many unknowns of miscarriage.

I’ve listened to women ascribe their pregnancy ending way too early to a wide-ranging and sometimes heart-wrenching set of reasoning: standing too close to an oven, standing too close to a freezer unit, playing tennis on a hot day, feeling overly ‘stressed’, getting angry at a partner, eating ‘off’ salad, eating too much, eating too little. I’ve even heard women suspect their pregnancy ended because they harboured doubts or fears about being a mother, or because the pregnancy was unplanned to begin with. I've heard men blame themselves in similar ways too, but the tendency, and force of it, plays out more inside the once-pregnant woman.

Women cannot escape the persistent, and insistent, cultural messages about how their bodies should look and be, and how it is that we should treat them. We are instructed — explicitly and implicitly — in how to eat, drink, exercise, move, pluck, tuck, boost and pose. We are judged dimly if we waver from the increasingly demanding ‘norm’, fuelled by social media (and despite advocacy for all types of bodies gaining voice). Such demands on how to 'behave' with your body also play out during a pregnancy, with women receiving various — and mixed — messages about what to eat, drink and do to protect their unborn. This makes it very hard to get pregnancy ‘right’ - easy fodder for self-blame when the pregnancy goes 'wrong'.

But of course there's one other psychological truth: mothers have an innate drive to protect their children from any harm, and inevitably feel guilty if they can’t achieve that. A woman in grief after miscarriage suffers the loss of a potential, yet also powerfully present, child in her mind too — it's just many others don't know this child, or recognise the mother's real relationship with it.

[1] The statistics vary in the literature and exact numbers will be impossible. In the UK we — and leading pregnancy loss charities — tend to quote ‘1 in 4’ although ‘1 in 5’ is regularly quoted too.