HEALTHY YOU

Miscarriage: Dealing with a pregnancy loss

Advice on how to help friends or family members who are grieving

#x201c;Driving home from the hospital with no baby. How can this be real?#x201d; was the middle-of-the-night tweet on Se
“Driving home from the hospital with no baby. How can this be real?” was the middle-of-the-night tweet on Sept. 30 from Chrissy Teigen. The model, author and mother of two and her husband, singer John Legend, had just lost their son, Jack, after pregnancy complications. The couple have posted on social media about their loss and their grieving process after the miscarriage. (Getty Images)

The series of black and white photos appeared on Chrissy Teigen’s Instagram account last fall. Teigen, a mother of two, had been actively documenting her third pregnancy on social media, providing updates even when complications landed her in the hospital.

The photos shared on Sept. 30, though, were unlike anything Teigen had posted in the past.

In one image, Teigen could be seen sitting hunched over on a hospital bed with her hands clasped in front of her face. Tears were visible on her cheeks. Another photo captured Teigen cradling a small blanket-wrapped bundle with her husband, singer John Legend, close by.

“We are shocked and in the kind of deep pain you only hear about, the kind of pain we’ve never felt before,” Teigen, 34, wrote. She later added, “To our Jack — I’m so sorry that the first few moments of your life were met with so many complications, that we couldn’t give you the home you needed to survive. We will always love you.”

The emotional post laying bare the couple’s grief over the loss of their baby was shared widely across social media. But amid an outpouring of support, some Twitter users attacked the parents for publicly mourning their loss — posting critical comments that experts say will only exacerbate an already painful experience.

“By placing judgments on how other people are experiencing their grief, we may be stigmatizing them, purposefully or unknowingly,” said Nicole Smith, a maternal-fetal medicine specialist in the department of obstetrics and gynecology at Brigham and Women’s Hospital in Massachusetts.

Even though miscarriages, stillbirths and neonatal deaths are not as rare as one may think, pregnancy loss is still not as openly acknowledged as other grief experiences, Smith said. This creates the perception that parents shouldn’t share their grief and “that these are problems that should happen behind closed doors,” she said.

In the United States, about 10 to 20 percent of known pregnancies end in miscarriage, according to the Mayo Clinic. Meanwhile, the country records about 26,000 stillbirths every year, meaning that 1 in 160 pregnancies that last at least 20 weeks ends with the death of a baby before or during delivery.

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“While people around them may not feel comfortable sharing their personal experiences or even know how to use the right words, the more that we can talk about it as a society, I think we’ll be able to move forward in supporting families through this grief,” Smith said.

“Some would say that it’s actually very generous of Chrissy Teigen and John Legend to feel comfortable sharing these heartbreaking images,” she added.

When Erin Wallace Morrison, 39, saw the image of Teigen, Legend and their son, she was reminded of a similar family photo taken after the stillbirth of her first child, Alice, in 2012. A subsequent tweet from Teigen, who wrote, “Driving home from the hospital with no baby. How can this be real?” also resonated with Morrison.

“I just remember leaving the hospital, and it just happened to be when all of the childbirth classes were coming in, so I was literally wheeled out in a flood of pregnant women coming in,” said Morrison, who now runs a support group for pregnancy loss and infant death in Washington, D.C. “It was just a surreal experience, where after a certain point, you just are in it and you are numb experiencing it.”

Though Morrison said she received support from her family and some friends in the weeks and months after, she got the general sense that “a lot of people just really didn’t know what to do.”

That’s fairly common, said Julie Bindeman, a licensed reproductive psychologist based in Rockville, Md. Unlike other types of loss, such as the death of a beloved family member or friend, it can be difficult to find people who have experience with a pregnancy loss, Bindeman said.

“We don’t have real language for it, we don’t have real rituals for it, we don’t have work and bereavement policies for it,” she said. “Up until probably about 15 years ago, which is fairly recent, if you had a pregnancy loss, your physician would say, ‘You know, just take a little bit of time, try again and forget this ever happened.’”

But rather than saying or doing nothing, experts and people who have experienced a pregnancy loss say there are a number of ways to support grieving parents.

Validate the loss

Pregnancy losses and the resulting grief can often be minimized or invalidated, even by people with good intentions, Rayna Markin, a licensed psychologist and associate professor at Villanova University, said in an email. “Miscarriages in particular are often viewed as a ‘nonevent,’” she wrote.

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Comments like, “You will get pregnant again, you’re lucky it happened early, or you just need to relax,” may do more harm than good, added Markin, who specializes in pregnancy loss and maternal mental health.

Bindeman recommended fighting the human instinct to want to make a person’s pain go away. “That kind of misses the point of grief, which is that pain is necessary because of the love we felt,” she said.

“Be genuine about how you comfort a person,” she said. “You don’t need platitudes. And, quite honestly, there is absolutely nothing you can say that’s going to be helpful, because none of us can bring back that baby, and that’s really what the person wants.”

Instead, Smith said consoling someone can be as straightforward as saying, “I’m so sorry for your loss.”

“Just that simple statement is enough to acknowledge the woman’s feelings and the woman’s lived experience and demonstrate that you care,” she said.

Morrison also suggested giving parents the chance to “share their love for their children in the same way” as those with living children do. Ask questions like, “Tell me about your baby, if you feel comfortable with it. What color was your baby’s hair? Who does she look like?”

Prioritize listening

You don’t always need to find the perfect words, said Pamela Geller, an associate professor of psychology at Drexel University.

“Almost every study about grief has acknowledged that listening is received so much better than having the right thing to say,” said Geller, who is the co-director of an intensive outpatient perinatal mental health program in Philadelphia.

Offer practical help and be specific

It is often difficult for people who are grieving to make decisions and plans, said Morrison, who recalled being unable to decide which showing of a movie to attend after the stillbirth of her daughter.

“If you’re trying to be helpful, suggest exact things that you can do,” she said. For example, Morrison said you can offer to walk a person’s dog and provide exact dates and times.

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It can also be challenging for a person in grief to ask for assistance, Bindeman said, meaning the onus is on you to reach out and “make a plan for them.”

Keep reaching out

Don’t wait for the grieving person to contact you, Bindeman said. For example, send a text saying, “I’m thinking of you,” or call and leave a message, she said.

Those reminders can be especially powerful during family-oriented holidays or the beginning of the school year — times during which parents may especially be remembering the child or children they lost, Morrison said.

Respect how parents are choosing to grieve

Everyone grieves differently, even if they may have shared experiences, Geller said. And people need to be given the time and space to mourn as they see fit.

Some parents may want to keep mementos of their child, ranging from photos to a lock of hair, Geller said. “There’s worry about forgetting the child, or if they go on to have another baby, that somehow that’s betraying the baby that died,” she said. “So, having those mementos allows them to hold onto their memories, feel some connection.”

Criticizing or trying to tell people how to grieve can feel “like an additional slap in the face,” Bindeman said. A pregnancy loss should be treated like a crisis or a trauma, she said. “I don’t think that anybody else gets a say in how I manage that.”

The Washington Post’s Gillian Brockell contributed to this report.

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