Icontact a friend and she tells me that she has recently experienced a perinatal loss. Anger, grief, disappointment, despair, pain—all tangled together. In addition, poorly chosen comments from people in her environment who try to be supportive but fail, further intensify her anger and deepen her sense that no one can truly understand her, leaving her feeling profoundly alone.
A loss that occurs during pregnancy is one of the most common, sensitive, profound, and invisible losses a woman may experience in her life. Miscarriage is not only a physical process but also a psychological loss—a relationship that is violently interrupted. For many people, the fact that there has not been a visible or tangible baby means a less significant form of loss. This, however, is not true. In practice, we see that the loss lies in the relationship: with the awareness of pregnancy, an imaginary attachment with the embryo begins, which often occurs even before conception. The woman and the couple talk about the baby, imagine it, make plans, and adjust their lives around this new reality. All of these are aspects of a developing relationship and make both the significance of this emerging existence and the magnitude of its loss evident.
The woman is burdened more, psychologically and physically, especially when she has to undergo painful medical procedures, which are often accompanied by cold or insufficiently sensitive treatment. The loss is equally real whether the pregnancy is at its beginning or its end. Grief may alternate with anger, guilt, despair, shame, and fear. Many women try to find “what went wrong,” as a human attempt to make sense of something senseless and painful. At the same time, hormonal changes and physical pain may intensify the traumatic experience and delay emotional processing.
Grieving does not concern only the loss of the embryo, but also the loss of dreams, fantasies, and expectations for the future. The formation of maternal identity, which had only just begun, is suddenly interrupted. This violent upheaval can trigger a deep existential crisis. At the same time, the partner also experiences a loss, often more quietly and less acknowledged. Their role is frequently ambivalent: they wish to support the woman, but struggle to speak about their own pain or even to understand how they feel. Society rarely recognizes their experience, resulting in many partners withdrawing, remaining silent, or trying to “be strong,” without allowing themselves to feel and mourn. This silence can create distance within the relationship, especially when the two partners grieve at different paces or in different ways. Feelings of loneliness, detachment, and lack of understanding often arise and may be expressed as tension or blame.
The reality is that each person experiences and processes grief differently and at a different pace. Unfortunately, the loss of an embryo remains socially stigmatized and is often met with insensitive comments such as “you’ll have another baby,” “it was meant to be,” or “just don’t think about it,” which not only fail to be helpful but also intensify feelings of loneliness and lack of support and understanding.
Grief is neither linear nor does it unfold in clear stages. Different emotions and thoughts coexist and alternate: denial and anger, fear and acceptance. Naming the loss, talking about what happened, seeking out people who can listen with sensitivity, and distancing oneself from words that diminish the experience can be relieving. Women need to care for themselves in different ways —for some, expression and discussion are helpful, while for others, silence and inner processing are necessary. There is no “right” way to grieve; there is only the authentic way for each person.
The course of processing is influenced by many factors: pre-existing anxiety or depression, previous losses, quality of relationships, level of support from the partner and family, the way the loss occurred, as well as the hopes and expectations that had been imagined. Especially in the early period following the loss, images or sounds related to babies may trigger intense emotions, and this is normal.
At such times, it may be important for the couple to turn to a professional for assessment and support. Psychotherapy, individual or couple-based, offers a safe space where thoughts and emotions that are difficult to hold elsewhere can be expressed. The woman can explore guilt, fears, and ambivalence, recognize her needs, and reconnect with herself without the pressure to “feel better.” For the couple, therapy can serve as a space for reconnection, strengthening communication, and understanding the different ways in which they experience grief. It is a process that does not negate the pain, but honors it and gives it space, so that it can gradually be transformed.
