After the loss of a baby, either due to miscarriage or stillbirth, what exactly is it that a mother goes through as she grapples with this devastating experience? Is it grief or is it postpartum depression? Could it be both?
This is an excellent question, and I wanted to follow up on my post this week about postpartum depression and miscarriages and stillbirths to discuss this further. Sarah Pollard responded to the post with a comment I wanted to highlight:
It can be confusing to sort out grief vs. depression as there are many commonalities. We must remember that grief is a very normal reaction to a very abnormal event (losing a baby) whereas depression/anxiety are disease states that need treatment. Grief in and of itself does not require treatment but instead support, education and understanding from appropriate parties.
Grief can get complicated (depression/anxiety can occur) and it can certainly excacerbate a pre-existing condition like depression, anxiety, Bipolar etc. Women who experience perinatal loss and have a history of any mental health issue should make sure their provider is aware of this history. Women should also be taught how to differentiate between grief and depression and when to seek help.
The typical postpartum depression support group, which usually contains at least a mom or two who is experiencing regret/ambivalence about motherhood, is not the optimal place for bereaved moms to find support. We know these feelings are normal with PPD but imagine the impact of such words on a grieving mother.
Mark, the husband of Paula (whose story was referenced in my last post), echoed these sentiments with he and his wife’s personal experience with depression after a miscarriage:
“One of the toughest parts of dealing with the postpartum depression after miscarriage was that there are some people who deal with and understand PPD and there are people who deal with and understand miscarriage, but there seem to be few people or resources to deal with the horrible combination of depression and grief that can come when you have both. To make it worse, some of the things that therapists worry about and try to stop in depression patients (like too much sleep) are normal ways of handling grief. There are a number of behaviors that have conflicting meanings or importance depending on if you view it as PPD, grief, or a combination of the two. It takes some real attention to treat them both.”
In her book A Deeper Shade of Blue, Dr. Ruta Nonacs discusses grief and depression after perinatal loss and the differences between them:
“Grief is not just feeling sad. It is a complicated, sometimes prolonged process by which you learn to cope with a loss and ultimately to move beyond it … The process of grieving requires time, patience and the support of others.”
She describes several stages of grief. Feeling numb at first, in total shock.Sadness. Then a time where you may be preoccupied with your loss, questioning why, having difficulty focusing on anything else, along with possible changes in sleeping and eating patterns. Experiencing anger and emptiness.
“With time, you will move toward acceptance of the loss and will be able to settle back into your life. It is unlikely that you will completely obliterate these painful feelings, but you will eventually be able to give them their allotted space in your emotional life … The symptoms of grief after a miscarriage typically last about six months to a year and do not usually affect your ability to function for a prolonged period of time; however, some women may have a grief reaction that is more intense or more prolonged. When the grieving process seems unbearably intense or seems to persist for a longer period of time, this may be a sign of what is called ‘pathological’ or unresolved grief, or this may be an indication that depression has complicated the picture.”
Nonacs states that depression is never normal, even for those who’ve had a loss, and it can impede recovery if not treated. I imagine it would be very important in this situation to keep in close contact with someone who can help monitor one’s grief and watch out for signs of depression.
In the meantime, I wanted to offer a few blogs and organizations that support grieving mothers and families, and would have more experience in understanding what these families go through:
- Unspoken Grief – A support community for those who’ve been touched directly or indirectly by miscarriage, stillbirth or neonatal loss. At this site, anyone can share their stories and learn from others. In addition to the forum, site creator Devan McGuinness educates readers on everything from the symptoms of grief to the causes and risk factors of miscarriage.
- Glow In the Woods – A blog dedicated to providing support to “babylost parents,” this site features beautiful writing by some bloggers you may recognize, including Kate Inglis of Sweet Salty and Bon Stewart, who formerly blogged at Crib Chronicles, as well as a few discussion boards.
- Silent Grief – Silent Grief offers weekly emails of encouragement to grieving parents, lists of reading materials, and an articles archive to help guide parents through topics like getting through Mother’s Day or answering the question, “How many children do you have?”
- First Candle – First Candle is dedicated to safe pregnancies and the survival of babies through the first years of life. Their current priority is to eliminate Stillbirth, Sudden Infant Death Syndrome (SIDS) and other Sudden Unexpected Infant Deaths (SUID). They have a specific section on their site for grieving families.
- Hygeia Foundation – They offer a bereavement resource lending library, funeral assistance to low-income parents, and educational programs to raise awareness among medical and other professionals of the effects of pregnancy and infant loss on families.
- Share Pregnancy & Infant Loss Support – Share offers a list of support groups around the country, information on parents’ rights when a baby dies, information on legislation related to infant loss and more.
- Bereaved Parents USA – The organization has chapters around the United States that hold local support group meetings for bereaved parents.
I don't know about it but really willing to get some knowledge about it.
Would you like to provide me some if you get?
Yes, it could be both, and therapists often miss the boat after a client experiences a perinatal loss by only addressing the grief. There can also be brain chemical changes in the woman due to the ending of the pregnancy. The woman's body doesn't know if there's a live baby or not – all it can tell is that the pregnancy is over and that triggers biochemical changes which for some can mean depression (or other mood or anxiety disorder). The point is, both the possible psychological and the biochemical pieces need to be explored and treated as necessary.
Shoshana Bennett, Ph.D.
Author, Postpartum Depression For Dummies and Pregnant on Prozac
I think it can be both as I have watched my wife suffer for weeks now at the hands of this unfortunate and devastating scenario. Not that I am not experiencing the exact same feelings of hopelessness, despair, anger, frustration & loss of faith at the loss of my son, but everyone in our life expects me to be fine in order to prioritize my wife’s feelings at the sacrifice of my own which I personally think is ridiculous. My wife IS my priority and always has been and I have done and continue to do my best to make sure she is as okay as is possible at this point but peoples opinions on how men should feel or act in this situation are, I feel, sorely outdated and selfishly misinformed. My wife had a miscarriage on August 28th (our first miscarriage experience), and I can honestly say as a military veteran and former police officer (disabled while on duty) it was the most gut wrenching and sorrow filled day of my life. I am the strong one that always protects my family (we have 3 daughters ages 11, 8 & 6) from everything and takes care of my wife and kiddos against anything that can hurt them but nothing ever prepared me for the helplessness and utter lack of control I felt when my wife screamed for me to help her and I walked in and saw what was happening. She had been having cramps and spotting at about 5 and a half to 5 weeks in and I kept calling her OB/GYN to get a sooner appt. but they were booked solid and no other doctor could see her any sooner so we spent many a night at the ER where we were constantly told everything looked fine and to go home. As her symptoms got worse I got more frustrated with the hospital and her doctor, I know there was more than likely nothing they could have done at that point but I still feel that had her doctor double booked her based on her symptoms or squeezed her in between other patients maybe my son would have had the chance to be here with us now. To be honest, we were quite terrified when she suspected she was pregnant, a fourth child is crazy difficult to raise especially when all of them are still living at home and rely on us to take care of and nurture three of them majority of the time and a new baby requires 24/7 attention. However, we just embraced the news and decided we were going to welcome this new little one just like our three before, and we were both pretty sure it was going to be a boy so we were extra excited although we just wanted he/she to be healthy and happy. Then the 28th of August came, and there is no feeling like seeing your wife in so much pain, shock and so emotionally destroyed and there wasn’t a damn thing I could do to make it go away or stop. I came into the room and after catching my breath and swallowing my own tears and choking down that lump in my throat I got my wife all cleaned up and cleaned up the room and got her into bed, I barely processed what had happened by the time she finally cried herself to sleep in my arms and I laid there the remainder of the night trying to figure out what I DID wrong. Of course I realize neither of us did anything wrong but at the time my rationale was that if I could find some kind of tangible excuse or reason behind it or even make it my fault, then my wife wouldn’t focus on what SHE might have done wrong or could have done differently; it may sound stupid now but I thought at the time even if she was mad at me at least she wouldn’t think horribly of herself or believe she was to blame. Since that day I have been trying to help her navigate her grief as best as possible and at what ever pace she needs to go while dealing with my own grief in the process and it has proven to be an extremely difficult task. If she knew how hard it is for me to choke it all down and help her she would feel awful and then she would be even more depressed and distant because she herself has said she doesn’t know what she would do if I wasn’t there for her and I’m afraid of what would happen if I was lost in grief myself, I’m afraid of what might happen and worry about my children’s quality of life while we are going through this loss. I will say this though: sexually, I am fine I mean I am ready to get back in the swing of things like normal before the miscarriage but completely understand how it must feel as a woman going through the same loss just felt in a completely different way and she knows that I am ready as soon as she feels okay to be intimate and I haven’t nagged or egged on about sex or intimacy since it happened, I just let her know I still love and am in love with her, find her sexy, attractive and a wonderful wife and mother and that nothing was her fault. I am far from perfect and still have, dare I say it, “man needs and desires” but a man can still feel that way and still be a loving provider and emotional “rock” for his wife, even if he himself can’t or doesn’t understand what his wife or partner is going through personally. That being said, I think a large majority of men simply cannot process emotions or feelings at the same level or capacity of their spouse or partner and I think a lot of women cannot grasp how some men process complex emotions like the loss of a child. I know, I’m a man and the first emotion that came to me was anger, because my wife was in pain and it was an enemy I could do nothing to stop or protect her from it and it killed me that I couldn’t make it go away and it still angers and upsets me that I can’t do anything against this intangible force that is threatening to unravel her sanity and emotionally wreck the woman I’ve loved and been in love with since I met her 15 years ago. So as far as your husband/boyfriend is concerned, I can almost promise you the issues he is having with this loss has more to do with how powerless he feels rather than his actually feelings towards you or your pregnancy and loss of your child and you have to both lean on each other instead of expecting your partner to carry all your weight; God bless them if they try too but you both need each other regardless of what gender roles or society has pounded into us how it should be, but you must recognize that there may still come a point where you have to just focus on yourself and your own grief and coping with it before you get dragged under a current so strong that you lose yourself instead of your husband or partner. Just my opinion about our struggle to cope and recover from OUR loss, and I know everyone’s situation is different and varied but I wish you all the best in this world and hope each and everyone of us finds the peace we need and deserve. God Bless.
Thank you for sharing this. It must’ve taken a lot to reveal such personal and painful memories. I absolutely hate that men are seen as weak if they cry. Men have emotions that shouldn’t be swept under the rug while they try to juggle their grief along with their family’s grief. Being it’s been over a year, I hope you and your wife are in a better place emotionally. ❤
I have had 3 miscarriages n my last one 3 years ago has left me almost debilitated .it feels like ptsd every time I see a pregnant woman…a baby…baby cries or other very small children. I at times use avoidance but sometimes have a curiosity which makes it self punishing.I don’t know when I ll ever feel or be the same for myself n my family. I can’t live like this anymore.
My name is Candice and I had a miscarriage on Feb 25,15 and I am not dealing w it well at all feels like I have no one who cares etc idk what to do
Hello Candice,
Firstly, I’m sorry for your loss. I really am. It IS a real loss and it makes sense that you are still hurting. It would be best for you to work on this in counseling. You are most likely dealing with repressed grief. And often women feel at fault for miscarriages, even though YOU ARE NOT at fault. Working through those feelings is healing. You will be able to feel better, but you need help.
I had miscarriage last 29 Feb 2016. Until now I still feel wasted. I longed for extra care and attention from the people around me but seems they are not aware what my needs are. It is the most painful experience…It would take me a lifetime to forget everything. I feel so lost.
Jeany, I’m sorry for your loss. I am sending you peace. I hope your are able to express your needs to your friends and family, to let them know that your pain is very deep and you are feeling lost. And if you feel like this is effecting your daily life, please consider professional help. You are grieving and talk therapy may be a really good place for you to start. Again, I’m so sorry for your pain.