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Unborn: A Psychologist's Grief for Early Pregnancy Loss

Personal Perspective: Understanding recurrent miscarriage and perinatal grief.

Key points

  • Grief for unborn children may follow early miscarriages, failed IVF, involuntary childlessness, or abortion.
  • Our culture lacks a collective understanding of early perinatal loss and shared language and practices.
  • Not feeling entitled to call my unborn children "babies" and myself a "mother” was at the core of my grief.
K. Mitch Hodge/Unsplash
A sculpture of a grieving person
Source: K. Mitch Hodge/Unsplash

When my partner and I decided to try for a baby, I was over the moon. I had already pictured holding a tiny creature in my arms, squeezing their little feet, and rediscovering the world through their eyes. How little I knew about the sorrows waiting around the corner.

Fast-forward to four early miscarriages, a life-threatening ectopic pregnancy, and a lost fallopian tube, I found myself in an alien place. No previous losses that I had suffered prepared me for this: the pain of perinatal grief coupled with the threat of involuntary childlessness. Even I, a clinical psychologist and psychotherapist, had little insight into the unspeakable pain of pregnancy loss and fertility struggles.

The agonizing grief after miscarriage

Discovering my first pregnancy felt as if someone had pulled back a curtain, revealing the most extraordinary place: one where a new life was growing inside me, and I was becoming a mother. My subsequent miscarriage abruptly blocked that breathtaking view. I had only taken a brief glimpse of it and yet, it was impossible to forget.

Peculiarly, after your body has completed the process of a miscarriage, the world does not go back to how it was. My life, all of a sudden, seemed somewhat barren. I, instead, remained preoccupied with what lay behind the curtain.

Transitioning from being pregnant to not being pregnant hit me hard. I struggled to comprehend this in-between place where I now found myself. In her book The Seed, Alexandra Kimball uses the word ‘unpregnant’ to describe a woman’s state of being after a failed pregnancy. The prefix ‘un’ signifies how a woman actively lacks a pregnancy. This word hit home. I felt so unpregnant. In a single moment, I went from having a new life growing inside my body to having nothing there.

Following my first miscarriage, my attempts to fall pregnant intensified. However, my hopes were raised only to be dashed again. As no miracles were coming my way, I entered a state of chronic sorrow. This is typical in cases of nonfinite loss, defined by Elizabeth Bruce and Cynthia Schultz as an enduring loss without a clear end in their book Nonfinite Loss and Grief: A Psychoeducational Approach.

How external reality complicates perinatal grief

“No, I am not depressed,” I snappily repeated to my loved ones, as they hopelessly tried to help by saying the wrong thing. I was sad, heartbroken, and beaten up by life. Yet I was not prepared to downplay the significance of my losses by calling them depression in our overtly medicalized society.

No matter how well-intentioned, my friends and family’s attempts for reassurance often made me feel lonelier. Such discussions usually involved untimely suggestions of IVF or adoption, and countless examples of women who had become mothers after fertility struggles. There was little space to share my uncertainty and sadness in the middle of what felt like toxic positivity.

What If I was not one of those women who lived happily after with their kids? What if I could not put myself through the heartache and agony of IVF? Most importantly, what about the pregnancies that I had already lost?

Some losses are easier to grasp than others. Early perinatal loss, subfertility, and involuntary childlessness — all the things I was struggling with — leave no clear traces of a new life. If anything, they concern the mere absence of life. They are examples of ambiguous loss. This is a term coined by Pauline Boss to describe unclear and undefined loss in her book Ambiguous Loss: Learning to Live With Unresolved Grief.

The politics of abortion further muddled my grief. Driven by my liberal views, I have always unquestionably supported women’s right to an abortion. As a result, I had unconsciously internalized narratives employed to defend abortion rights. Such narratives often implied that an embryo or a fetus was not a person. How could I fully grieve when I had an ingrained belief that the loss of an unborn child was less of a loss?

 Yaoqi yaoqiqiqilai/ Unspalsh
Woman grieving after miscarriage looking at the sea
Source: Yaoqi yaoqiqiqilai/ Unspalsh

The attachment to the unborn child

Only after the mist cleared was I able to see the bigger picture. Early pregnancy loss is a fairly new concept. Home pregnancy kits only arrived in the early 1970s. Prior to this, an early miscarriage or a failed conception was often not even acknowledged as something real.

Grieving a loss that is not socially validated is disenfranchised grief, according to Kenneth Doka, a professor emeritus at the graduate school of The College of New Rochelle. Yet, the vanished child and their unlived life are very present psychologically in their mother’s mind and fantasy. This is something that Julia Bueno discusses in her book The Brink of Being.

So, what was I grieving for each time I lost a pregnancy? None of my five pregnancies went beyond six weeks. No heartbeat was detected in the ultrasounds. Was I entitled to grieve for a baby? Or five babies? The term stillbirth is used to describe a pregnancy loss after the 24th week of pregnancy. If I were to grieve for five lost babies, then this would make me a childless mother of five, an entirely foreign concept.

It took me a while to acknowledge that I had formed a strong attachment to my lost babies — yes, they were babies in my mind — before their conception. I loved them dearly despite never meeting them. During each loss, I grieved for the little soul that never fully entered into a body nor given a chance at life.

Women grieving their unborn child may include those who have experienced early perinatal loss (before 24 weeks gestation), failed IVF, involuntary childlessness, and termination of pregnancy. In fact, the experiences of perinatal loss and abortion share several similarities, as Greer Donley and Jill Wieber Lens discuss in their article "Abortion, Pregnancy Loss, & Subjective Fetal Personhood". Ultimately, it is the mother’s attachment to her unborn child that acts as a barometer for the presence and profoundness of perinatal grief.

Navigating grief for baby loss

Navigating perinatal grief is often far from simple. This loss is neither tangible nor always visible. Our sociocultural context can further facilitate or hinder grief. Initiatives, such as the recent government publication of the "Pregnancy Loss Review" in England, are encouraging. Among other things, it is finally possible for the English bereaved to ask for a certificate to be issued for any loss pre-24 weeks’ gestation. This could indeed help facilitate grief.

The U.S. Supreme Court's overturning of the right to abortion may have created an obscure landscape for grieving for unborn children. Grief for early perinatal loss, concerningly, runs the risk of being weaponized by abortion polemics. Such fear could push some grieving parents to embrace the opposite view — that an embryo is not a person — which could then complicate grief.

Regardless of the wider context, navigating through the loss of an unborn child remains a deeply personal experience. Indeed, I also had to find ways to adapt to my losses. Some included keeping a miscarriage grief journal; counselling; writing a letter to my unborn children; reading Saying Goodbye by Zoe Clark-Coates; and taking part in the Wave of Light event during Baby Loss Awareness Week. The above practices helped me channel my grief and honoured my babies’ memory. My unborn children have undeniably left an indelible imprint on me, which I am immensely grateful for.

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