Grief is defined as the emotional response to the significant loss of something or someone important in your life. It is the process a person undergoes to overcome and adapt to such a loss. There are many types of grief, among which we find disenfranchised grief. This type of grief occurs when society does not recognize the loss of a third party or does not allow the bereaved to express it. It seems unbelievable, doesn’t it? In what situations do you think this type of grief could occur?

One of the experiences in which this occurs is in perinatal grief. Perinatal loss is defined as the loss of a baby by a pregnant person from the time pregnancy is known until the first month of the baby’s life. One of the most common causes of perinatal loss is miscarriage. Miscarriage is defined as the premature loss of the baby during the first 23 weeks of pregnancy. Within miscarriage, there is (1) early miscarriage, which occurs from conception to the thirteenth week of pregnancy, and (2) late miscarriage, which occurs from the fourteenth week to the twenty-third week.

According to statistics, it is estimated that the risk of miscarriage in pregnant people is 25%. It is even believed that this percentage could be higher, as many losses occur before the person is aware of their pregnancy. Twenty-five percent means that 1 in 4 pregnant individuals will lose their baby spontaneously. That is, if you have a group of 10 people and they all become pregnant, it is most likely that at least 2 will lose their baby. Shocking, isn’t it?

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The Dreaded Phrase “Me Too”

Miscarriage is a taboo subject; many people have experienced it but have not communicated their loss. It is only when someone brings up the topic that many others are encouraged to talk about it. But why is something so painful taboo? There are several reasons why this happens:

  1. Miscarriage Grief is Not Socially Accepted: The person’s circle expects less suffering.
  2. No Funeral Rituals: This creates the feeling that the loss should not be mourned.
  3. The First Trimester Rule: Pregnant individuals often wait until the third month of gestation to announce their pregnancy. Thus, when miscarriages occur during this period, the environment is unaware, making them feel more alone, isolated, and unsupported.
  4. Medical Desensitization: Since it is not a life-threatening situation nor one with a solution.
  5. Lack of Understanding: As explained by the Theory of Ambiguity, is one of the most influential factors in the grief process.
  6. Dissatisfaction with Treatment and Lack of Preparedness: By healthcare professionals to address the issue.

The Consequences of Miscarriage

It is not difficult to put oneself in the shoes of someone who has had to live through this experience. The loss of an expected baby can be considered a traumatic event, becoming one of the most painful life experiences for parents. Therefore, the psychological consequences are many and varied:

  • Anxiety symptoms
  • Depressive symptoms
  • Post-traumatic stress
  • Intense emotions of grief, guilt, anger, and shame
  • Isolation
  • Stigmatization
  • The feeling of “empty arms”
  • Natural grief processes
  • Complicated grief processes
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Expected Grief

Grief is a necessary process to go through to integrate our losses. According to theorists like Worden, there are several tasks you need to accomplish in the face of a loss:

  • Accept the reality
  • Work through the emotions and experience the pain
  • Adapt to a world without the loved one
  • Reposition and remember the loved one

The emotions we go through during grief are not comfortable, but that doesn’t mean they are negative or unnecessary. On the contrary, no matter how much we want to «get rid of them,» they will help us heal. Therefore, experiencing them does not imply a problem. However, in some cases, the experience can become complicated, and it is advisable to seek professional help.

How Can I Identify If I Am Experiencing Complicated Grief?

According to the ICD-11, the following criteria may indicate that you are experiencing prolonged grief:

  • Separation distress: longing for the lost person and/or intense feelings of emotional pain, sorrow, or distress present daily and intensely.
  • Confusion about one’s role in life or a diminished sense of self.
  • Difficulty accepting the loss.
  • Avoidance of reminders of the reality of the loss.
  • Inability to trust others since the loss.
  • Bitterness or anger related to the loss.
  • Difficulty moving on with life (e.g., making new friends and pursuing interests).
  • Emotional numbness since the loss.
  • Feeling that life is unfulfilling, empty, or meaningless since the loss.
  • Feeling stunned, dazed, or shocked by the loss.

When these symptoms appear and (1) at least six months have passed since the loss and (2) the mentioned symptoms are clinically and significantly disrupting the person’s daily life, both socially and occupationally, it is recommended to seek professional help.

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Therapy Can Help

Whether experiencing expected or complicated grief, therapy is a place of validation and psychological support. Moreover, having gone through an experience that remains a taboo topic in society, therapy provides a space that acknowledges this social reality.

Although grief is a natural reaction, it is an idiosyncratic phenomenon and should be considered with the personal and contextual characteristics of each individual. Therapeutic approaches such as Cognitive Behavioral Therapy or Acceptance and Commitment Therapy could help navigate these processes.

Finally, I would like to emphasize that perinatal grief due to miscarriage is a profoundly painful experience that deserves to be recognized and validated both personally and socially. Despite being a taboo subject, it is essential to know that you are not alone in your pain and that you have the right to express your emotions and receive support. The lack of recognition and social prejudice can intensify your suffering, making it crucial to foster an environment of empathy and understanding. There is no need to go through this alone, pretending nothing happened; share it with someone you trust. And if it doesn’t go well, there will always be professionals who can offer you a safe space to process your loss. By acknowledging the validity of your grief, we can begin to break the silence and provide the necessary support to navigate this difficult experience.

About the author

Laura Redondo Fidalgo is a Clinical Psychologist and Neuropsychologist at Sinews. She works with a wide range of issues, including anxiety, depression, grief, self-esteem, and interpersonal relationship problems, among others. Her approach is cognitive-behavioral, but she also incorporates tools and techniques from other modalities, such as Third Generation Therapies, adapting to the specific needs of each patient, thanks to her continuous training.

Laura Redondo
Division of Psychology, Psychotherapy and Coaching
Laura Redondo
Children, adolescents and adults
Languages: English and Spanish
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