IF AT FIRST YOU DON’T CONCEIVE

I found the following passage helpful, taken from Dr. Schoolcraft’s book, If at First You Don’t Conceive: A Complete Guide to Infertility from One of the Nation’s Leading Clinics. This passage was written by Deb Levy, one of CCRM’s psychological counselors.

– Highlight Loc. 1784-1831

DEB LEVY one of our clinic’s psychological counselors, has a lot to offer patients who’ve experienced multiple miscarriages, so we asked her to offer some guidance to our readers, too.

Women who have suffered multiple pregnancy losses may experience extreme symptoms of grieving. As discussed in the book On Death and Dying, by Dr. Elisabeth Kubler-Ross, grieving can include many different emotions, and patients who have suffered miscarriages often experience a wide range of feelings, including symptoms of depression and anxiety. These emotions may feel magnified after a miscarriage, so counseling can be beneficial.

It is not uncommon for those suffering multiple pregnancy losses to turn their anger, a normal aspect of grieving, upon themselves. They may blame themselves and wonder what they could have done to prevent the miscarriage. It is not uncommon, either, to have patients who’ve suffered recurrent miscarriages say they feel guilt or shame. Often, women say, “I feel like a failure.” Others may feel that they were unable to carry out one of the most basic “tasks of womanhood.” So, they may find themselves feeling like less of a woman, less of a wife, or simply inadequate.

Patients and medical staff have noted that some of the terminology used by doctors and nurses doesn’t help. When patients hear us talk of “failed IVF cycles” and “habitual aborters,” they can’t help but feel emotionally drained.

American culture hasn’t come to terms with grieving and loss as well as other cultures. That is why many couples choose not to tell others of their pregnancies in the first trimester. They are hesitant to “disappoint” their friends or family members who might enthusiastically follow the pregnancy.

This reluctance to talk about early pregnancy is especially common among those who have suffered multiple pregnancy losses, as they don’t want to go through the process of explaining the loss time and time again. There also may be the fear that others will blame or judge them.

All couples have a right to privacy, of course, but you don’t want to get in a situation where you are alone with your grief, without the support of friends or family members and the perspective they can provide. The stress of grief and the feelings of guilt or shame can be too much for one person or even a couple to bear alone. It may be even dangerous to your emotional and physical health. So this is not something you want to go through alone. Understand that grief is a natural process and nothing to fear or be ashamed of, but if ever there is a time when you should lean on those closest to you for support, this is it.

We also have patients tell us that when they reach out to friends and family after losing a pregnancy, they sometimes get responses that, whether intentional or not, seem hurtful, insensitive, or less than supportive. The fact is the even those close to you may not know exactly what to say in such cases, and sometimes, they may not express themselves well. The same thing happens at funerals and wakes, when people sometimes say inappropriate things simply because they are at a loss for words at such an emotional time.

Those who have suffered multiple pregnancy losses also may experience symptoms associated with posttraumatic stress disorder. In these cases, the miscarriage may be replayed in one’s head over and over so you feel as though you are constantly re-experiencing the trauma. As a result, you may feel depression or anxiety at high levels. Or, you may shut down emotionally so that you feel empty, or without hope. Typically, patients in that frame of mind say things like “I’m never going to have a baby.”

Physical manifestations, such as insomnia, flashbacks, or nightmares, can also be apparent with posttraumatic stress. Following a loss, many patients also report a desire to get pregnant again, and sometimes this is coupled with a conflicting and very intense fear of getting pregnant again.

Patients who have suffered multiple pregnancy losses report significant emotional and physical stress, so counseling and group support are strongly recommended. There is no instant cure for the very natural process of grief, unfortunately. No counselor has the ability to simply make the emotional anguish go away, but counseling can help you understand your emotions as valid and normal.

It can also help you manage your grief if you memorialize or honor the loss with a ceremony or funeral. I also recommend support groups, where you can share your feelings and find others who have been through similar grief. Often, there is no better way to get through your grief than to see that so many others have gone through the grieving process and emerged from the experience as stronger people.

I counsel patients to practice good self-care through journaling, meditation, exercise, counseling, massage, or other coping tools. These can help you manage both the emotional and physical manifestations of loss.

Nothing can quickly remove emotional pain from the loss of a pregnancy, and as long as you understand that grief is a natural process, you can allow yourself to feel all the various emotions that may arise. You should not feel it necessary to force yourself to feel better or to hide or bury your emotions, because they will manifest themselves in other ways, even unpredictable ways. We’ve had patients who’ve stifled their grief only to find themselves breaking down in their cars or offices, or lashing out at loved ones or coworkers “for no reason.”

It helps to know that while you may never forget the lost pregnancy, you can expect to accept it one day and then move on; one day you will again feel like your normal self.
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