Miscarriage Trauma Involves Mental Health Need
Step into an examination room at an OB-GYN, and you may find a young couple staring up at a monitor. Little by little, their pure love, joy and anticipation illuminates the room, burying any sense of worry or cautiousness they may have.
But as they both stare up at the monitor–anxious to see and hear the long-awaited music of the beating heart of their first child–they are met with silence. Their radiant eyes become like icicles melting in the sun as they realize that their child is gone forever.
Miscarriages are more common than one would think. Approximately one in four women will lose their baby to miscarriage. According to the American College of Obstetricians and Gynecologists, it’s the most common cause of pregnancy loss, with 80 percent of all miscarriages happening within the first trimester.
Sadly, that one-in-four statistic drives a stigma of commonhood that overshadows the true devastation of miscarriage, allowing friends and family on the outside looking in to feel compelled to offer words of encouragement rather than words of compassion: It’s God’s will; There was probably something wrong; You’ll be pregnant again before you know it.
This stigma makes it incredibly difficult for parents, especially those who miscarry within the first trimester, as their grief may be less socially acceptable or acknowledged than the anguish of someone who miscarried beyond twelve weeks gestation, leaving the grieving mother feeling that her loss is not valid.
“I think it tends to be more of an afterthought,” said Dr. Benjamin Keyes, professor and director of training and internship at Divine Mercy University. He is also the director of the Center for Trauma and Resiliency Studies, which offers training towards certification as Mental Health First Responders in times of disaster and traumatic situations.
“I think parents losing a child is the most devastating of losses,” he said. “I don’t think it ever fully heals. For some parents–depending on how strong their mood towards parenting is–it may actually stop them from the process out of fear of experiencing it again. I don’t think people realize just how bonded parents become to the fetus, nor the emotional changes that happen, certainly within the mother. When there’s a miscarriage, we think ‘well, it almost was.’ We move on and that’s the end of it. But that’s not the case for the person who has gone through the hormonal changes, those shifts in the body. That’s not the case for the people who were in preparation to becoming parents only to find themselves not being parents.”
As miscarriage carries a physical toll on the mother, it also takes a toll mentally, and can be a trigger for mental health issues including depression, panic attacks, flashbacks, nightmares, and anxiety. The grief is comparable in nature, intensity, and duration to that in people who suffer other types of major loss, and a 2016 study showed that four in ten women who experience miscarriage experience symptoms of PTSD.
Julia Bueno, a psychotherapist in London, England, has experienced miscarriages herself and specializes in working with women who have experienced pregnancy loss. She is also the author of The Brink of Being: Talking About Miscarriage, where she explains that, despite how common miscarriages are, most are never mentally or physically prepared for the firsthand experience.
“Many women,” she writes, “don’t expect it to happen and are not prepared for what it may involve: neither the potential physical–and possible medical–endurance nor the roller coaster of competing and complex feelings that the grief for a lost pregnancy can involve. The sadness, guilt, self-blame, sense of failure and worthlessness, anger, and uncomfortable envy can surprise or even shock the bereaved, who bear all this with no sure sense of how or how long to grieve, nor confidence to talk about an experience that has been relentlessly silenced.”
In addition to the unexpected mental and physical toll, most mothers find themselves at a loss in finding the strength to overcome such a tragic and traumatic experience that’s seen more as an afterthought. But according to Divine Mercy University professor and senior scholar, Dr. Paul Vitz, the struggle is not due to a lack of strength. As part of the module for Dr. Keyes’ course, COUN 640: Crisis and Trauma: Prevention and Treatment, Dr. Paul Vitz explains why some people who have experienced traumatic obstacles may struggle to overcome them.
“I think in many cases,” he said, “the person who has failed to overcome those obstacles is not without many strengths and could really overcome them. But they haven’t been given any guidance. They haven’t been given any help. They haven’t been shown any strategies that might work.”
Fathers are also affected by the same grief and, for them, the grief is twofold. First, there is grief for the mother, but also feeling an overwhelming sense of needing to set all grief and emotions aside in order to be strong for her. But then there is the individual grief for the loss of their baby with whom they had already forged a bond. This twofold grief can develop into what psychologist Dan Singley sees as the most common reaction for dads who experience a miscarriage: a profound sense of guilt.
“The guilt is very often the result of the fact that he himself is struggling,” said Singley, who is also the media chair for Postpartum Support International. “He’s got a lot of anxiety and depression but doesn’t feel entitled to it — kind of like, ‘Hey, I’m not the one who lost the baby, so what right do I have to be taking up her emotional bandwidth with my issues?’”
As our knowledge of the mental health risks and consequences that arise with miscarriages and infant/pregnancy loss grows, so does the need for mental health professionals to intervene with those parents in their time of need. The students at Divine Mercy University are being trained to address these parents’ needs as they cope with their grief. And the faculty work on both training the students and developing coursework that helps them be prepared to reverse the stigma around some of the less visible sources of grief, like miscarriage.
“We do a lot in terms of parents,” said Dr. Keyes. “That is certainly a focus of the Catholic Christian Meta-Model of the Person (CCMMP): parenting and thriving within families. I think it does a good job in addressing family issues. I also think the focus in our courses does the same as we discuss family processes and family struggles across the lifespan of a person.”
The Catholic Christian Meta-Model of the Person is unifying framework that integrates philosophy and theology with the psychological sciences. As one of the nation’s leading graduate institutions, Divine Mercy University is training students to identify, address, refer and treat both individuals and families who are suffering from depression, PTSD and other trauma-related disorders, with the specific mission to help patients flourish through the lens of the CCMMP. One excerpt from the document shows this focus on the family:
Interpersonal relationality is first developed in the family, which is the basic unit of society. Humans have both a natural need for family and natural inclinations to establish families, that is, inclinations toward the goods of marriage and the procreation and education of children. All families, regardless of structure, deserve support, including assistance for the difficulties they face (Chapter 2).
“That’s one of the functions of the helping professions,” said Dr. Vitz, “to give opportunities for new growth–for new flourishing–as a way of overcoming things that, in the past, the person was really depressed by or felt controlled by and felt, if you will, victimized in a way that made them passive, sad, withdrawn and without hope. That’s one of the things our programs focus on: How to provide strategies and ways of overcoming the past so that you can move hopefully and positively into a more flourishing life.”
Access to psychological services through the IPS Center at Divine Mercy University are available on a sliding scale basis. Services are offered by supervised doctoral students and are available to both adults and children. For more information, call (703) 418-2111) or email firstname.lastname@example.org.