063: 8 things to know about pregnancy & infant loss
On mourning in motherhood
To our valued readers: This week, we’re coming to you with an issue on pregnancy and infant loss—timed with its month of awareness, which extends through October. It’s not lost on us that we’re discussing personal loss and grief during a time of profound global loss and grief, wars across oceans, reproductive rights under fire, natural disasters marring parts of this country, and more. We are holding space for all the mothers, children, and families who are facing loss, grief, pain, and suffering right now. We urge you to check in on yourself, check in on your loved ones, and protect your heart (meaning: consume this issue, and any media you want to, only when you are in the right space to do so). If you need extra mental health support, utilize the resources throughout this issue. Be well. —Cassie and Kelsey
Today is Pregnancy and Infant Loss Remembrance Day, and October is Pregnancy and Infant Loss Awareness Month. If you’re one of the many mothers who has experienced either, you likely don’t need this reminder every year. Loss is something that stays with you; it’s grief.
Traditionally, grief tends to be a grieving of the past—memories of when you were little after a parent passes, for example—but a wonderful perinatal mental health professional, Dvora Entin, LCSW, PMH-C, once told Cassie that pregnancy loss is uniquely painful because it is a grieving of the future: what almost was; a picture in your mind forever changed; celebrations that never came.
We tend to support people we love through times of grief in other areas of life by attending funerals, sending sympathy cards, or honoring loved ones’ lives. But too often, pregnancy and infant loss are met with invalidation, toxic positivity (“You’ll get pregnant again!” or “At least you have another child"), or, perhaps worse, with no acknowledgment at all. If you’re the one going through these types of losses, it can feel hard and isolating; if you’re the one wondering how to help, you might be unsure how to do just that.
Grief can be many things. It can be painful. It can be shared, and connections can be built as a result of it. It can also be compared (read: I shouldn’t feel so upset since I don’t have it as bad as others)—a dangerous game that hinders our ability to validate and process our own grief. You can fight it. You can make peace with it. It can make you feel like no one on Earth could possibly understand what you’re going through. You can sit with it. You can sit with someone through it.
If you’re grieving a loss—a pregnancy, an infant, a child, or otherwise—our hearts are with you. If you haven’t experienced loss, you likely know someone who has. Use this month as a time for learning, a time for supporting those around us who are struggling, and a time for community. Use the eight important takeaways to help you or a loved one find comfort.
Save this issue. Pass it on to a friend in need. Or just take it to heart.
There is strength in numbers. If you experience pregnancy or infant loss, you may feel like you’re the only one who is going through what you’re going through. But about 10 to 20 percent of known pregnancies end in miscarriage before the 20th week. In 2022, the infant mortality rate in the United States was 5.6 deaths per 1,000 live births, a 3% increase from 2021. You are not alone.
Pregnancy loss almost always results from something out of your control (read: not your fault). About 80 percent of pregnancy losses occur within the first trimester, and about one-half to two-thirds of those occur because of chromosomal abnormalities.
Your friends who have experienced loss need you. Not sure what to say or how to help? Read Cassie’s recent story in Women’s Health: “What To Actually Say To Someone Dealing With Fertility Issues (And The Language To Avoid), From Women Who Have Been There.”
Support can help you through the darkest days. If you’ve experienced loss, groups such as Postpartum Support International (PSI), Resolve, and The Miscarriage Doula offer online support groups for pregnancy and infant loss. PSI also provides access to a specialized loss coordinator and hosts a directory of trained providers should you want one-on-one care. Arden Cartrette, the founder of The Miscarriage Doula, also provides 1:1 coaching (follow her @themiscarriagedoula). PSI provides a list of many other resources and groups specific to various types of loss and support, too (such as support for caregivers, non-profits that support those who have experienced the death of a child, and more) here.
Words are powerful. Loss can all too often be excruciatingly isolating. Yet, as Kelsey wrote in this round-up of pregnancy loss experiences and perspectives for Motherly, “there’s something poignant about reading a passage and thinking, yes, that’s exactly it; that’s what I was struggling to understand. I see myself and my heart reflected in these words.”
The right kind of loving reminders of a lost life can be beautiful. In Cassie’s recent Women’s Health story about supporting a friend through pregnancy loss, mothers shared poignant stories about gifts they’ve received after loss—acknowledgments of life, beauty, and pain. One woman spoke about the plant she was given by a friend after a stillbirth—something she takes care of to this day and watches bloom throughout the seasons. Her mother also gave her a necklace with a baby carriage on it. “I had struggled with the fact that when I walked around the world, no one knew what happened … The necklace served as a way to share, a talking point,” she said.
We need more research on pregnancy loss. There is important research being done on pregnancy loss. One such project: Stanford University School of Medicine, in partnership with the University of California, San Francisco, and the Oregon Health & Science University, is embarking on a study called The Hope Project to learn more about the causes of pregnancy loss. If you’ve experienced pregnancy loss, you’re eligible to enroll in the group’s registry to learn more about the causes of miscarriage.
Language around loss matters. Many mental health professionals don’t use the word “healing” when it comes to grief. In many ways, grief isn’t something you heal from; it’s something you grow with. It’s something you learn to stand side-by-side with. Something else to consider if you’re supporting someone through loss: Listen to how a loved one speaks about their loss, and try to mirror it. For example, do they use the word “fetus” or the baby’s name? Do they say they “lost a pregnancy” or a “lost a baby”? Following someone’s lead on language can help you meet them where they are in their grief.
» Editors’ note: FWIW, in this newsletter, you’ll notice that we tend to use the term “pregnancy loss” more often than “miscarriage.” Some advocates in the space have noted that the word “miscarriage” can insinuate a mistake, badness, or error—ideas that can be internalized by a mother. It’s not wrong to use the word miscarriage—and we will use it occasionally—but this is something to be aware of when discussing loss with loved ones.
Special thanks to Fello for sponsoring this issue
You’ve probably heard us say this many times: You were never meant to mother alone. But not everyone has the benefit of a built-in village—trusted people who provide support, information, or conversation. That’s where Fello comes in. Fello is a new online peer support platform for topics such as parenting, relationships, and more. Fello can connect you with a trained support person who has lived experience around the issues you’re working through — including infertility, pregnancy loss, or the death of a child. Book a ‘Fello’ to find support, guidance, and resources from someone who truly understands.
Get your first check-in for free: Click here and use the code TT2024
In July, the Stillbirth Prevention Act was signed into law
“Over 21,000 babies are stillborn every year, and it’s time for this silent crisis to come to an end," said Congresswoman Alma S. Adams, Ph.D., co-founder and co-chair of the Black Maternal Health Caucus. "We owe it to our mothers to reduce or remove the unnecessary risks that have made pregnancy unsafe. Thanks to the Stillbirth Prevention Act, we will address this injustice so more mothers and babies experience a healthy birth and make it home with their families.”
Related reading: More links about loss
“It’s Time To Talk About Miscarriage & The Workplace” via Romper
“This poet wrote about his wife’s miscarriage and many can relate: Read ‘We Cry, Together’” via USA Today
Doula Kimberly Summer Denitz-Zuleger looks back on her own loss, via Instagram
Thanks for reading, ‘liking’, and sharing this issue
But first, we’re sending a very warm hello to the several hundred (!!!) new subscribers who have joined us recently—welcome! (Click here to check out past content and get caught up.) To subscribers new and old, it’s an honor to be in your inbox; Two Truths will always provide select free content to our subscribers. Paid subscribers also have access to our breaking news takes, expert interviews, tips (for sleep, travel, and everything in between), product recommendations, and more special features. To support this work (done between naps, after bedtimes, and before school pickups!), please upgrade to a paid subscription. Also, hit the heart button to tell us you enjoyed this issue, share it on social media by tagging @twotruthsmotherhood on IG), or forward it to a friend. We appreciate you. —Cassie and Kelsey
Resources and Support For Maternal Mental Health
Emergency assistance is available 24/7 at 911
The National Suicide Prevention Lifeline is available 24/7 at 988
The National Maternal Mental Health Hotline (1-833-TLC-MAMA or 1-833-852-6262) provides access to a trained counselor 24/7 and is available in Spanish and English
Postpartum Support International provides educational resources on PMADs, free support groups, webinars, advanced trainings for providers, and more
Postpartum Support International’s provider directory includes a list of thousands of trained professionals organized by state
The Motherhood Center offers counseling, support groups, and webinars
The Postpartum Stress Center offers educational resources, counseling, a referral list of trained providers, and advanced training for providers
SUPPORT YOUR MENTAL HEALTH WITH POSTPARTUM SUPPORT INTERNATIONAL (PSI). PSI is a global champion for perinatal mental health that connects individuals and families to the resources and support needed to give them the strongest and healthiest start possible. Visit postpartum.net for information on perinatal mental health disorders, access to 30+ free, online support groups, an online provider directory, the PSI HelpLine, local support coordinators, a perinatal mental health discussion tool, specialized support resources, and more. Call the PSI HelpLine toll-free at 1-800-944-4773 for basic information, support, and resources. Support via text message is also available at 800-944-4773 (English) and 971-203-2773 (Español). Remember: You are not alone. You are not to blame. With help, you will be well.