Please note that some terms in this post may serve as a trigger. Take caution and care of yourself while reading through.
This post is not meant to diagnose or treat your miscarriage or loss. If you are experiencing symptoms of miscarriage or loss, please call 911 or head to your nearest emergency room.
Around 1 in 4 pregnancies end in a loss (probably more, as early miscarriages sometimes happen prior to people even knowing they are pregnant). While this is a common occurrence, I still hear the same feelings surrounding it: isolation; loneliness; inadequacy; shame. Women feeling as if their bodies are broken or that they just aren’t good enough, as if they’ve done something wrong and don’t deserve to become pregnant and carry to term. So this year on October 15th for National Pregnancy and Infant Loss Awareness Day, I am wanting to educate more on what loss really is, and how expansive it can be defined in the hope that someone can commiserate their own experience with someone else’s. Maybe they were brushed under the rug at the doctor or didn’t have the terminology for it, or maybe they were too ashamed to look more into what happened. Let this post act as a quick, insightful guide to build your own terminology and settle/grieve into your own experience of loss.
Medical terminology often belittles actual emotional response. Please note that the education in this post is not meant to minimize any feeling that has been felt. Let yourself feel.
Miscarriage: Miscarriage can be defined as the loss of a fetus before it can survive outside of the uterus, typically occurring before the 20 week mark. Language differs nationally, but often times miscarriage can be split into first trimester and second trimester loss. Note that most miscarriages happen in the first trimester, primarily between weeks 5-8. Second trimester loss can vary depending on how the loss is defined by the medical professional, but are around 1 in 2 of every 100 miscarriages and are put into this category from weeks 13 - around 24 weeks gestation.
Chemical pregnancy: A chemical pregnancy is a form of a miscarriage, and happens very early, within the first 5 weeks of gestation. In a chemical pregnancy, women may test positive, have symptoms of pregnancy, but never progress. This type of miscarriage is overwhelmingly common, and often gets dismissed by medical providers, leaving an emotional gap and lack of understanding for the carrier.
Ectopic Pregnancy: This loss is characterized as when a fertilized egg implants outside of the uterus. About 90% of the time, the egg implants in a fallopian tube. This occurs when something blocks or slows the eggs travel to the uterus. This can have a very serious and sudden onset, and can lead to internal bleeding or dangerous ruptures.
Stillbirth: A stillbirth occurs when a pregnancy is lost through the death of a baby in the womb, occurring after 20 weeks gestational age. We can categorize stillbirth similarly to miscarriage, in separating into early (20-27 weeks), late (28-36), and term (37 weeks of later). While reasons for stillbirth may vary, many common occurrences can be attributed to placental or umbilical chord problems, infections, or fetal birth defects. However, a large number of stillbirths, just like miscarriage, go unfounded.
Termination for Medical Reasons (TFMR): This loss occurs when a pregnancy is ended due to fetal abnormality or critical risks to the carriers health or life. For very unfortunate and quite often political reasons, this is often overlooked as a loss. However, grief, sadness, shame, and emotional distress are consistent with TFMR, just like the other defined forms in this post.
Neonatal Loss: A neonatal loss is defined as a loss of a live-born infant before the first 28 days of life. An early neonatal loss occurs within the first 7 days, while a late neonatal loss occurs between day 8 to 28. While the majority of neonatal losses occur in the NICU, not all do. Some common causes of neonatal loss are low birth weight and prematurity, intrapartum traumas, infections, and congenital anomalies.
Infant Loss: An infant loss occurs up to the first 12 months of life. Some commonly linked causes are genetic conditions, low birth weight, or Sudden infant Death Syndrome (SIDS). This is often unspeakable and unimaginable for families.
IVF/IUI Loss: While not commonly recognized as a loss, I wanted to highlight IVF and IUI’s as a grieving experience in addition to the others. This can mean a failed transfer or implantation. Couples that endure IUI’s or IVF have most commonly been through natural attempts at pregnancy or struggled with conception. To make it to IUI and IVF is generally a grueling journey, so the disappointment and grief that comes with a failed transfer must be recognized as a loss in itself.
Infertility & Secondary Infertility: Infertility in itself is vaguely defined, and often times doesn’t leave couples with a lot of clarity. It becomes loosely defined after attempting to become pregnant with no interventions after 12 months of trying without protection. Secondary infertility is the inability to conceive after a successful pregnancy and birth. Also difficult to fully understand, couples question their ability to grow their family and often times turn within to self blame.
While education is a starting point, it is not the answer to working through grief and loss. The many aforementioned feelings of shame, disappointment, inadequacy, and loneliness are meant to be felt through this process, not fixed. The purpose of this post is not to intellectualize, but to help women know that they are not alone in their loss, that these have definitions because they aren’t uncommon, that they are not, and will never be, your fault. Please consult a therapist for support if you’ve been through or are currently experiencing any of these losses. To advocate for yourself is the greatest gift, and to soften and feel only allows that further.
