What happens to relationships after the loss of a pregnancy, and do men and women grieve differently? While this has been the focus of much academic literature, I would like to share my clinical experiences. Of course, these experiences are not necessarily representative of all grieving men and women, but I hope my observations can be useful to couples walking the path of pregnancy loss. If nothing else, always remember that there is no "right" way to do grief: your experience is your own, and it is always reflective of the love you felt, and continue to feel, for your baby.
Q: In your clinical experience, are relationships more likely to end after babyloss?
A: I have seen no evidence for that in my professional practice, as well as in my personal relationships with friends who have experienced pregnancy loss. I have found that the heartbreaking and sometimes traumatic experience of pregnancy loss creates an opportunity for increased growth and more open communication. While there is deep sadness when a pregnancy ends prematurely, I have found that couples are often motivated to talk about the meaning of their baby's life, and how wanted and loved that baby was. This unites them and creates a point of meaningful connection. From there, I often work with them to create meaningful memorials of their child, and we often discuss if and when a couple would like to try to conceive again.
The greatest relationship challenge I have encountered is ensuring that each member of the partnership is committed to being open and honest, and avoiding projecting his or her experience of loss onto the other. Sometimes, grief causes us to jump to conclusions or make assumptions about how our partner is feeling, instead of simply asking, "How are you doing?" or making a statement of observation like, "I notice you aren't crying as much as I am. Why is that? Do you feel sad?". It's so, so important to avoid letting concerns or assumptions about your partner circle around and around in your head, where there is a risk of them becoming irrational or making you feel resentful. Instead, work on using "I statements" to begin the conversation, such as, "I feel like I never see you cry" instead of "Why aren't you crying?". It is useful to address your thoughts and feelings with a mediator in therapy, or to even write them down. I have truly observed that the loss of a baby can ultimately bring loving couples closer together, if they're committed to being vulnerable with each other and keeping lines of communication open.
Q: Do men and women grieve differently?
A: I think they do. I find that women turn within themselves, and focus on the loss of their special relationship with the baby that they carried, especially in the experience of women who end a pregnancy in the second trimester. Often receiving news of a seriously ill baby is shocking and unexpected, with limited time to decide what to do. After the pregnancy ends, mothers begin to feel the full depth of grief they have experienced, and the intensity of this emotion can cause them to isolate, detach, or spend more time crying and reminiscing. They may avoid eating and spend more time sleeping. They also experience bodily changes including bleeding and lactation that serve as painful reminders of the loss, which may create extra sadness or worry.All of these are very normal reactions. Across pregnancy loss, from miscarriage to ending a wanted pregnancy to stillbirth, I find that it is common for mothers to blame themselves and their bodies for not being able to carry a healthy pregnancy and take care of their child. There is much self-doubt and blame.
The loss reactions of fathers tend to be a bit different, and I often observe them grieving for the loss of their children as well as for their spouses or partners. Often, men tell me that they feel hopeless and helpless to support their partners, and wish that they could carry the grief for them. They understand that their connection and bond to the baby was different, and they may feel that the loss does not feel as real to them as it does for their partners, because they may have never held the baby or even seen much more than an early ultrasound. When men experience stillbirth, this may be less likely, as they may have had the opportunity to meet their child. I have observed that men tend to focus on tasks that they can accomplish in the aftermath of grief, such as going back to work and resuming a "normal" schedule, or getting to work taking down the nursery or making repairs around the house. This, too, is normal.
Q: Do couples always need counseling after the loss of a child?
A: No, but it may be very helpful. The experience of babyloss is unlike any other grief that you may have previously encountered in life, and you may be surprised by your own reactions. Because grief never exists in a vacuum, there may be triggers in your relationship with your spouse that impact how you cope. It may be hard to identify why you feel frustrated or angry with your partner, but you may be feeling especially raw and sensitive.
Remember, going to therapy is not a sign of weakness; it's actually a sign of strength. Creating a commitment to working on communication and understanding your partner's perspective can reinforce the foundation of love and commitment you have already established. One goal of therapy is to have an outside professional help you both understand how your grief experience affects your partner, so that you can better understand how to improve communication and understanding moving forward.
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