The most difficult and painful event of pregnancy is the loss of a developing fetus to whom the mother has closely bonded, decisions around termination of pregnancy, and coping with abnormalities in the infant. These events can be crushing to parents and can sometimes be devastating to a marriage; they call for the utmost love and generosity on the part of the two partners and great compassion and patience on the part of family members and caregivers.
When mothers, when parents, face these same issues, their reactions almost always have some element of guilt and of blame for both themselves and their partner. Insofar as these feelings occur commonly, they are normal - but they can be horribly destructive, affecting personalities adversely and destroying relationships.
The most important thing I tell my patients is that the tragedy is not their fault and not their partner's fault - their body has not failed them; there is not something they should have done differently. The fact that they have a particular genetic makeup or developed a medical complication is not a matter for blame and guilt. Pregnancy and birth are so miraculous - from two cells that meet and multiply, a new human being is formed. It is a complex process, this everyday event, and at any stage, things can go wrong. The fact that most of the time everything goes perfectly is in itself amazing.
As painful as the even is, the mother and father need to share the labor and delivery of a child who is incompatible with lie just as closely as they had planned to share a joyous birth. In olden days, when babies were born dead or died just at birth, mothers were discouraged from even seeing the baby. Now we realize what a cruel thing this is - no to see this tiny loved one who has been inside you, been a part of you, for so long. No matter how tiny the baby, it is important that the mother and father be able to see it; this is an essential step in coming to terms with the loss.
Both partners need to support and to accept support from each other. For some couples, the loss of an infant or the birth of a child with abnormalities can bring the marriage to a crisis stage, and the couple may need help not only in confronting their grief but in dealing with issues in their marriage that have surfaced with their loss.
The needs of other children in the family must also be considered, and the parents, especially the mothers, need the time to grieve their loss before considering another pregnancy.
Daphne was a 42 year old professional woman who had had four miscarriages. In each pregnancy, she lost her baby at seven to eight weeks. When this happened for the third time, she consulted a specialist in difficult pregnancies. The doctor discovered that Daphne has an unusual condition that does not allow her to carry the pregnancy past eight or nine weeks. Research into this particular condition continues however, this therapy is still in the early stages of investigation.
When Daphne had miscarried for the second time, her family doctor asked me to see her. She is still exploring the possibility of pregnancy, however, there are other issues she has to deal with - for example, her advancing maternal age, her repeated experience with grief, and her apprehension about carrying a baby to term at her age.