Cultural Silence and Pregnancy Loss

Did you know that miscarriage is the most commonly occurring perinatal loss, impacting 15-25% of all pregnancies and 25% of all pregnant women? That means that you, or someone you love likely experienced at least one miscarriage. But guess what? They probably didn’t tell you about it. Miscarriage is one of the best kept secrets in our society. 

Cultural Silence and Shame

Women face considerable distress during and after a miscarriage or perinatal loss. The distress can lead to depression, anxiety, posttraumatic stress disorder (PTSD), grief, guilt, and shame. There is a culturally sanctioned silence that increases a woman’s sense of isolation and shame and compounds her grief surrounding the loss. Society tends to minimize miscarriage as a nonevent and people often make well-meaning but callous remarks. 

People feel uncomfortable talking about pregnancy, because society lacks the language for it. Well-meaning friends and family say things like, “Well, everything happens for a reason” or “Hopefully it will stick the next time!” These messages interrupt the grieving process and prompt a woman to internalize her grief. This, in turn, increases her sense of shame and self-blame. As a culture, we stay quiet, treat it as a medical nonevent, and lack culturally scripted ways to mourn and grieve. The cultural silencing places immense stress on women and their partners. 

Couples and Motherhood

Our cultural scripts prioritize motherhood as part of a woman’s identity. Pregnancy loss catapults a woman from a hope-filled pregnancy to a sudden state of shock and grief that strips the woman of her status as a mother. There are a lack of supportive resources or cultural norms on how to handle the loss, and couples feel confused about whether to have funeral services or how to mourn. 

The complex social and personal influences such as cultural silencing, lack of mourning rituals, grief, and PTSD, anxiety, and depression, place immense stress on a couple’s relationship. Couples have difficulty discussing a miscarriage, and both men and women may hide their emotions and grieve alone rather together. This lack of communication can lead to distancing and stress in the relationship.

Men also experience grief but lack appropriate social support and ways to talk about their loss. They experience many of the same feelings as women. Men feel isolated and alone but often attempt to suppress their grief while prioritizing the well-being of the woman. 

Miscarriages at Work

Most women continue to work during a miscarriage to maintain the secrecy. Working during a miscarriage only increases a woman’s sense of isolation in the workplace as she struggles alone with the physical pain and emotional challenges. If women were given the appropriate time away from work and cultural scripts to mourn and grieve, this trauma is unlikely to impact her work.  

Grief

Grief surrounding pregnancy loss differs from other deaths because there are not shared memories—only a hope for a future, now shattered. Multiple miscarriages further compound the grief and a person’s ability to cope as couples lose hope in future pregnancies. 

Anxiety 

Many women do go on and become pregnant again, but most struggle with anxiety surrounding the health and well-being of their developing baby. The women tend to distance themselves from the pregnancy as a way to protect themselves from disappointment if they suffer a miscarriage again. Women are often unable to experience happiness and joy in subsequent pregnancies.

How to Care for Women

A woman’s social support circle is immensely important during a miscarriage and in the months following. Offer to sit with her, accept her tears, listen, and offer gentle words of support such as, “I know this hurts. I’m here for you.” You can offer the same support to her partner who is also grieving. Do not be afraid to bring them a meal, call them, or ask to stop by and visit. Leaving a woman or couple alone to grieve increases their sense of isolation. You can also offer her support if she goes on to become pregnant again.

You can break the cycle of silence surrounding miscarriage. We can create mourning rituals and ways to talk about our grief. Whether you are a friend, family member, medical provider, pastor, or therapist, you will likely encounter women and couples experiencing miscarriage and perinatal loss. We must provide compassionate care and encourage these women to seek counseling support if you see signs of depression, PTSD, anxiety or other mental health concerns. Couples can seek therapy to process their loss and improve communication. 

You are Not Alone

If you are reading this post and experienced a miscarriage or perinatal loss, I want you to know that the feelings of sadness, confusion, emptiness, anger, disbelief, shock, and disappointment are normal. Our silence increased your sense of isolation and encouraged you to internalize feelings of shame. I, too, experienced this during my own pregnancy losses. Please share this post with someone you know who is hurting. We can alleviate women’s suffering by starting the conversation. 

Rebecca Ray is a Marriage and Family Therapist Associate and the owner of Modern Family Therapy, PLLC. She is under the supervision of David M. Lawson, LMFT-S, Lic. #2137.