BY LINDA WASMER ANDREWS

Miscarriage is a common occurrence, but that knowledge may be cold comfort if you’re coping with a recent loss. In fact, many women are surprised by the intensity of their emotional reaction after a miscarriage. The feelings can run the gamut from shock and sadness to irrational guilt and anxiety about future pregnancies. Men, too, may struggle with feelings of loss and inadequacy, especially if they’re unsure about how to help their partner through this difficult period.

Rest assured that such feelings are perfectly normal. The emotional healing process after a miscarriage may take some time — often much longer than the physical healing takes. But allowing yourself to grieve the loss can actually help you come to terms with it in the long run.

Dealing With Feelings
Technically speaking, a miscarriage is a pregnancy lost before 20 weeks. Most miscarriages are caused by a genetic abnormality that keeps the fetus from developing normally. Everyday activities — such as exercising, working and having sex — don’t cause miscarriages. Yet many women still blame themselves. If you’re questioning whether the miscarriage occurred because of something you did or didn’t do, reading articles such as this one or talking with your healthcare provider about the causes of miscarriage may help ease your concerns.

In the weeks after a miscarriage, many women experience a roller coaster of emotions. At the same time, a woman who has just miscarried is going through hormonal shifts as her body readjusts to not being pregnant. Her changing hormones may intensify the emotions she’s feeling.

Grieving Your Loss
“Unfortunately, some women get the message from family and friends that they shouldn’t feel such a sense of loss,” says Denise Côté- Arsenault, Ph.D., R.N.C., an associate professor at the University at Buffalo School of Nursing. This attitude is particularly common when the miscarriage occurs early in pregnancy, as most do. But an early loss isn’t necessarily easier to handle than one later in pregnancy. “A woman may have been pregnant for only eight weeks, but she might have been planning to become pregnant for the previous two years,” says Dr. Côté-Arsenault.

If you’re a woman who has been through a miscarriage, remember that you’re entitled to your feelings, whatever they may be. Remember also that some women are hit harder than others — there is no right way to feel. Allow yourself to experience the grieving process in your own way and at your own pace. “You may feel fine one day and horrible the next, and that’s OK,” says Dr. Côté-Arsenault.

Sharing and comparing experiences with other women who have been through the same thing is often reassuring. Joining a support group may help. If your feelings start to interfere with your ability to get along in daily life, or if your sadness doesn’t lessen after a couple of months, talk with your healthcare provider. You might benefit from a referral to a mental health counselor or therapist.

Coping as a Couple
Men and women typically respond to a miscarriage differently. Often, men shift into problemsolving mode when faced with a crisis. They may end up feeling helpless and inadequate when they aren’t able to “fix” their partner’s grief. Miscommunication is also a common problem. In a classic scenario, “every time a man brings up the baby, his wife cries, so he learns not to talk about the baby,” says Dr. Côté- Arsenault. “She gets the message that he doesn’t care. But he does care — he just can’t stand to see her so upset.”

Kristen Swanson, Ph.D., R.N., a professor at the University of Washington School of Nursing, has researched the effect of a miscarriage on couples’ relationships. She found that about onethird of women say that they feel more distant from their partner one year after the loss. To prevent this kind of distance, Dr. Swanson advises men to show how much they care. For example, they can watch the other children, do the dishes or take their partner out for a special dinner. Some couples in Swanson’s research were actually drawn closer by the miscarriage. These couples’ secret? “The men opened up and talked about their feelings,” Dr. Swanson says.

Ready to Try Again?
A common question many women have after a miscarriage is when they’ll be able to try again. Ask your healthcare provider what’s best for you. In general, the first menstrual period occurs four to six weeks after a miscarriage. It’s usually safe to conceive after one normal menstrual cycle. At times, though, you might be advised to have medical tests first to determine the cause of your miscarriage. Also, your emotions may need a little more healing time than your body. It’s best to wait until you’re ready physically and emotionally before getting pregnant again.

Fears about suffering another pregnancy loss are common after a miscarriage. The reality is that most women who miscarry go on to have a healthy pregnancy the next time around. Don’t hesitate to talk with your healthcare provider about any concerns you may have. Your support network comes in handy now, too, especially if it includes women who’ve had successful pregnancies after a loss. Dr. Côté-Arsenault also suggests keeping a pregnancy calendar or journal to track your pregnancy milestones and record your feelings. She says, “Some women find that once they put their emotions on paper, they don’t have to hold them inside, and so they feel better.” With time, the fears will lessen, and hope for the future will return.

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