DEAR DR. JENN,
I had a miscarriage three months ago and I am still devastated. My husband was upset at the time but now he has moved on. He thinks I should “get over it.” He really wants to hurry up and try again, and I feel so weird and touchy about even having sex after what I went through. I am so disappointed by his lack of sensitivity. We have never faced a crisis like this before. How do we get on the same page? —Double Loss
It is well known that no one says the right thing to someone who has been through a pregnancy loss, and unfortunately that extends to the partners who are supposedly going through it with us. But, you are not alone. While the miscarriage rates vary depending on maternal age and trimester, on average, 10 to 25 percent of pregnancies don’t make it to full term. It has been estimated that as many as one million women suffer miscarriages a year. So that means many of your peers have gone through something similar — and so have their relationships.
And the effects of pregnancy loss on a relationship are well documented, too. Couples who suffer a miscarriage are 22 percent more likely to break up. In my clinical experience this occurs for a number of reasons. Typically, in the case of heterosexual couples, men and women tend to grieve differently, which can cause a lot of stress on the relationship. When the woman carries the baby (as opposed to a surrogate) she physically feels different and usually starts to feel like a parent sooner than her partner. She has to make sacrifices — what she eats, drinks, and does — usually as soon as she sees the plus sign on the pregnancy test. This forces her to feel the connection to motherhood sooner, while the non-gestating partner (whether that's a man or not) is not physically experiencing this momentous life change. The reality of parenthood may hit them later, which means the reality of the loss is less severe.
Then there's the issue of actually losing the pregnancy: For you, or any woman who experiences it, miscarriage can mean weeks of bleeding and almost flu-like feelings. It can mean going to an abortion clinic for a D&C procedure to remove a fetus that won't pass naturally but isn't progressing. There's a lot to deal with on an intimate level, and even the most supportive partner is just there for the ride and to (hopefully) say "how can I help?" or to show up with snacks. The best thing you can do is explain (in as much detail as works for your relationship) just what you're going through. What the pain feels like; why you need so many pads. They won't get it, but they should be able to get you and understand that you are experiencing something (or have experienced something) very tough, messy, and distracting. Even in the best case scenario that won't leave someone feeling sexy right away.
Add to that baseline experiencing the pregnancy loss differently that many men have not been taught to be in touch with sad, vulnerable feelings, so it is challenging for them to work through grief. Even while showing up for you to rub your back and say "I'm sad too," they may not be able to really dig into the "well this fucking sucks" level of what you're going through.
Society also teaches men they need to “fix” things. Because a lost pregnancy is so un-fixable, it can make a person quick to gloss over it so they can move forward out of the uncomfortable feeling of being ineffectual. (This can also be behind an urgency to "try again," to try to replace the lost pregnancy. Of course, getting past your grief is not that simple!) As with any other life stress, all of this can combust in a relationship and lead to fighting. You may be fighting about laundry, or bills, or your sex life, but the underlying pressure on your relationship can be traced back to not seeing eye-to-eye on something so major. Here's what you need to know to move forward from a pregnancy loss together (and stay that way).
Grief and Loss in a Relationship
Most couples go through the typical stages of grief and loss after a pregnancy loss: denial, anger, bargaining, depression and acceptance. They don’t necessarily occur in any particular order, and you don’t graduate from one and move on to the other. You can alternate back and forth between different stages. In addition to those stages, many people who experience a pregnancy loss also feel guilt. They question if they did something wrong (“Could it have been that glass of wine I had before I knew I was pregnant?”) or could have done something different. (“If I hadn’t moved that doctor’s appointment back, might he have caught a problem and prevented this miscarriage?”)
Feeling jealous of friends or, even, stranger who are having babies or healthy pregnancies is also normal. It is hard to struggle with these feelings when someone you love has a baby after you lost yours. These feelings don't feel good and it's hard to own up to them. Sometimes they can cause conflict within the couple (“Why can’t you just be happy for your sister?” “I don’t even understand what this has to do with us!”). For some couples a miscarriage is the tipping point for an already troubled marriage. Writer and miscarriage survivor Shelly Weston wrote about this type of experience poignantly in the Huffington Post. For her, the miscarriage was the beginning of the end of her marriage. For you, it doesn't have to be.
How to Get Through Pregnancy Loss as a Couple
1. Talk about your feelings. A recent study of couples post-miscarriage found that women who perceived that their partner was sharing feelings and experiences felt closer both personally and sexually. The experience of sharing grief brought them closer. It's important to know (and help your partner know) that any range of feelings can be normal after miscarriage: from sadness and grief, to relief. Expressing the range of what you're experiencing can help your partner open up about their perspective.
2. Appreciate your differences. It is actually a good thing, when one person is struggling, that the other person is in a better place so they can be there to support their partner. If it seems like he's "totally fine" then maybe lean on him for extra support while you are not. But also understand that just because your partner is not showing their grief the way you are, it doesn’t mean he is not grieving.
3. Perform a grieving ritual. If you are feeling a lack of closure on the pregnancy and that's what's preventing you from feeling ready to "move on," there are rituals you can try to honor the pregnancy that was lost. This is especially helpful in families who experienced still birth or other later-trimester pregnancy losses. Some people have a funeral service of some kind, plant a tree, or even get a tattoo in the lost baby's honor, which maternal mental health expert Dr. Jessica Zucker has explored as part of her #IHadAMiscarriage work. It can help to do something that is meaningful to commemorate the loss.
4. Stay away from blame. Miscarriage and pregnancy loss is no one's fault, and we are each responsible for our own feelings and responses. Blaming one another only drives a wedge between you, and won't help either of you move forward. Instead, agree that something awful can happen — and be no one's fault or responsibility — so rather than finding a "reason" for what happened, you can put your energy toward finding happiness and comfort again afterward.
5. Get support. There are great support network online for couples who have lost a pregnancy. Connect with other people who are experiencing the same type off loss. If one or both of you feels stuck in your grief, you may want the meet with a therapist to talk through it.