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In the UK, it is estimated that 1 in 4 pregnancies end in loss during pregnancy or birth. As a woman, it has to be one of the most traumatic things you will experience in your lifetime. With so many women finding themselves in these traumatic circumstances, losing a baby at any stage is in fact shocking and traumatic for both parents. To mark the close of Babyloss Awareness Week 2020, we invited Dr Petra Boynton – social psychologist and Agony Aunt – in this Q&A around coping with miscarriage and pregnancy loss.

What are the different feelings and emotions you may experience after miscarriage or pregnancy loss?

There are many of them that can occur during or immediately after a loss, and some can occur together. The most common ones are distress and grief, despair, disbelief, shock, numbness, uncertainty, fear, anger, denial, jealousy, panic, losing confidence or feeling like you’ve failed.

Some people also experience relief but this may not be something they feel comfortable sharing. Some of these feelings can be unpredictable and overwhelming and we may be shocked at how strongly we react.

We can also be surprised that we don’t react in ways we thought we might (for example you might feel sad but you may not cry, or you could find yourself laughing hysterically during a sombre moment).

How are partners effected by pregnancy loss and how may their emotions mirror or be different?

We used to only think of partners as husbands, but we now use the term ‘partners’ to be inclusive of all kinds of relationships (partners could refer to boyfriends, girlfriends, wives and may be someone you’re with or an ex).

We also used to think that partners/husbands didn’t feel any kind of grief or sadness, or if they did it was much less because they’d had no physical loss. Research has shown repeatedly that partners can experience the same emotions as I’ve listed above, but may not feel it’s appropriate to share.

They talk about having to be strong, or worry if they talk of their feelings that it’ll seem like attention seeking or add to the struggle their loved one is already going through. Often partners are discouraged from seeking help and can struggle to find places for support. This may mean they don’t discuss how they feel or hide their emotions in overwork or avoidance. It might give the impression they don’t care and that can lead to tensions and communication problems within relationships.  

What are the ways a miscarriage/pregnancy loss can impact your relationship with your partner?

Some people find their relationship is strengthened, that the loss brings them together. Others feel it harms the relationship temporarily or permanently. Shock and trauma can be a factor, as may the way the loss was dealt with and whether wider family are supportive and sympathetic.

If there are disagreements or people are made to feel they’ve failed, caused the loss or not reacted in expected ways that can cause divisions and rifts. Some people want to be intimate very soon after a loss, either for comfort or to try again to get pregnant. Others don’t want any kind of intimacy for weeks, months or years.

This might be due to mental health problems (including depression or anxiety), or psychosexual issues like vaginismus, premature ejaculation or erection problems. If you want to have another baby but can’t due to not wanting sex, not being able to have sex or fertility issues that places greater strain on relationships (particularly if using assisted conception).

It would be surprising if pregnancy loss didn’t affect a relationship so seeking support from charities, groups or counselling could be vital, especially if you feel there’s a barrier between you but don’t know what to say or do about it. 

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We talk a lot about the emotional symptoms of pregnancy loss, but what about the physical symptoms thereafter?

There may be pain, bleeding and soreness (including breast tenderness). Some people bleed for some while after a loss and sometimes infections can be a cause for concern so if you notice bleeding that seems to be getting heavier, clotting, a smelly discharge or just feel unwell it’s good to see your GP.   

It’s also common to experience problems with your sleep (insomnia, bad dreams or early waking); appetite changes (going off food or eating more than usual); tiredness and exhaustion; and struggling to concentrate and focus. Some people are very tearful and cry and experience mood changes, or may feel anxious or nauseous. If you find your symptoms are worsening or other people around you are worried about your mental health then again it’s good to talk to your GP.

What is your advice for telling people you’ve miscarried or experienced pregnancy loss?

It’s a very personal decision who you tell and when. Some people are discouraged from announcing they’re pregnant before 12 weeks which can then make it difficult to disclose a loss. It’s up to you if you want to say that you’re pregnant – or that you aren’t.

It may be if you’re struggling you ask a friend or other family member to share the news. You can say so in a text, email, by phone, in person or on social media. Whatever is the most appropriate way for you.

It may be you tell different people at different times (for example, you tell immediate family when the loss happens or shortly after, but tell others weeks or months later or during Babyloss Awareness Week or Mother’s/Father’s Day).  

What ways and coping skills can you share to help with the grief of experiencing pregnancy loss?

Everyone is different, so how you want to deal with grief will be personal, but people say the following have helped them:

– Giving their baby a name and encouraging others to use it

– Having a funeral or memorial service

– Making a memory box or book with scan photos (if available), poetry or other meaningful things. This might include photographs taken of you and baby (for a late miscarriage or stillbirth) or a blanket baby was wrapped in

– Buying a piece of jewellery to wear (perhaps that has your babies name on it, or their fingerprint)

– Fundraising for a babyloss charity or the hospital where you were cared for

– Having a tattoo with an image that represents your baby or their name and/or significant date- Raising awareness about loss with others

– Getting out into nature or a place where you feel you can be peaceful and connect with your baby

– Music, poetry or film can help- Some people take comfort from their faith

– Talking with others about your feelings, or about other things that make you feel safe and comforted

– Nothing. Not everyone wants to remember or do anything particular. If you wish to continue life as ‘normal’ for you, then that is always an option. 

If you had to offer some words of support to someone reading this who has just experienced pregnancy loss it would be…

I’m sorry for your loss. There is help available for you. Allow yourself to grieve in your own way and in your own time. Don’t be afraid to ask for help if you want to. If you need support, use groups, charities and the babyloss community. It’s a club nobody wants to join, but you will find comfort here. 

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Anything else you’d like to add?

A few things, if I may: Babyloss, like many areas in society, is unequal. Black women are twice as likely to have a stillbirth and five times more likely to die in childbirth. Black and Asian women are also less likely to have their concerns noted and may experience racism within healthcare.

Women, non binary and trans men can experience pregnancy or babyloss and their partners may be any gender; not everyone who experiences a loss is in a relationship and especially may not be married – we need to recognise families can be very diverse and you are still a parent (and a family) if your baby died.

If you’ve had a loss and need help, it’s okay to be specific about what you need (e.g. “please could you do my shopping?” or “I need someone to take me to the hospital”). If you’re supporting a friend, don’t wait for them to ask, offer your care. Keep checking in, especially over time when people can feel forgotten. If they’ve named their baby, use their name. Be there to listen, even if you aren’t sure what to say. 

While there are efforts being made to improve our understanding of why losses happen and the care offered to those who’ve miscarried (including ectopic and molar pregnancies), or had a stillbirth or infant death, care can be a lot better. If you’ve had a loss and the care you received wasn’t good, it is important to ask for help from charities should you need it and feed back to the hospital via PALS so improvements to care can be made.

We’re all focused on loss during Babyloss Awareness Week, but you may want to remember your baby throughout the year. If it’s important to you to talk about your baby with others, to share their photos (if you have them), write poetry or otherwise express your grief, don’t let a fear of other people’s reactions stop you. The more we talk about our losses the easier it will be for others to feel they are not alone when they go through theirs (noting, again, that this is a personal choice and nobody should be pushed to share anything against their will).

If people want advice or help about their losses, however long ago they happened, there’s a list of support groups here www.copingwithpregnancyloss.com/support and you can reach me through that website if you have any questions or want further information.

Author bio

Dr Petra Boynton is a social psychologist and Agony Aunt. She has a PhD in Applied Human Psychology and works as a consultant in International Healthcare Research. Her research focuses on sexual health, safety and wellbeing and she has applied this work through advising charities, NGOs and policymakers. This includes acting as a consultant to the Department of Health and the BBC World Service Trust on public health messaging.

Petra has created documentaries for TV and radio on sexual health concerns, including the award-winning documentary “Impotential” for BBC Radio 4, and as a consultant presenter on Channel 4’s The Sex Education Show. Since 2002 she has worked as an Agony Aunt in print, broadcast and online media including Men’s Health, Grazia, The Telegraph, More! and BBC Radio 5 Live.

In 2014 Petra ran a public awareness project for the Miscarriage Association identifying the needs of partners affected by pregnancy loss and resulting in a multimedia project (film, cartoon and an information booklet) that generated global press coverage. This campaign, alongside people seeking help through her advice columns, plus practitioners needing training to support patients during and after loss, along with her own experiences, led Petra to write Coping With Pregnancy Loss .