For many women, it begins with that little blue stick in the bathroom, the one with the two blue lines. "I'm going to have a baby," you mumble as you clutch the thin barometer bearing the story of your future.
If you haven't had a child before, you may start daydreaming about decorating a nursery or about baby names. If you already have a child, you may start devising new floor plans or anticipating how your older child will cope.
Once the pregnancy is confirmed by the doctor's office and a due date issued, it seems official. The date is plugged into the Palm Pilot. Pregnancy books are either purchased or dusted off. Some close family and friends may be told the jubilant news.
Then the unthinkable occurs. The pregnancy results in a miscarriage or a stillbirth.
In a large number of cases, the formerly pregnant woman is told to just move on, to focus on the next pregnancy. She and the father often aren't given the time to grieve the loss, pregnancy loss experts report. Well-meaning friends and family members avoid the topic, acting as though the pregnancy never existed. Some physicians may behave clinically or with an emphasis on, "It was for the best."
To mental health professionals, the denial of pregnancy loss simply compounds the grief the woman and her partner feel, forcing them to swallow or conceal their sorrow when they really need some acknowledgement of their pain, or permission to mourn. And considering that at least one in 10 pregnancies ends in miscarriage—some say it's as high as a quarter of all pregnancies—social workers and counselors say that's a whole lot of women enduring a whole lot of anguish, in need of a better support system both from their doctors and from their friends.
Nancy Hemenway said it was breathtaking how little emotional support she received following each of her four miscarriages. "I really think that there are still a lot of obstetricians who pat you on the head and say, 'Well, at least you know you can get pregnant,'" said Hemenway, who co-founded the Virginia-based INCIID, the InterNational Council on Infertility Information Dissemination.
The group, which runs a website offering specialized medical information and emotional support for infertility and miscarriage sufferers, was created from Hemenway's desire not only to obtain information about the causes of miscarriage, but also to give women a place to turn when no one else wants to talk to them. "I remember screaming into a pillow wondering what in my life I could've done to deserve this," she said. "People would say, 'Just adopt,' or 'Maybe you weren't meant to have children.'"
The sadness she felt following her miscarriages was profound, she said. "I couldn't look at a pregnant woman without crying," she said. She grew angry with family and friends who thought she should've "gotten over it" after what she considered to be a brief period of time after each loss. While Hemenway sought counseling, she said she went through a couple of therapists before she found one who could meet her needs.
Though she eventually had a daughter and adopted another child from China, Hemenway said the miscarriages still haunt her. And it haunts many others as well. According to Share, an international pregnancy and infant loss support group, there are an estimated 900,000 early pregnancy losses and 27,000 stillbirths in the United States each year.
Peg Beck, the clinical director for Resolve of the Bay State, a Massachusetts-based support group for people with infertility problems and pregnancy loss, said Hemenway's long lasting grief is not uncommon. "A lot of people hold onto those [miscarried or stillborn] babies in a profound way," Beck said. Even with early miscarriages—losses in the first few weeks of pregnancy—these women "didn't lose a mass of tissue, they lost a child," she said.