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Published October 05, 2013, 10:00 PM

In Depth: Miscarriage. Emotional, physical components of miscarriage not always understood

Fargo - Kari Dahlen wasn’t trying to get pregnant. It wasn’t a good time, with her mother losing the fight against cancer.

By: Sherri Richards, INFORUM

Fargo - Kari Dahlen wasn’t trying to get pregnant. It wasn’t a good time, with her mother losing the fight against cancer.

After a positive pregnancy test Dec. 1, Dahlen shared the news with her mom in her palliative care room. Barbara Gebeke was thrilled.

“She was super excited to be a grandma again though we knew she wouldn’t be here a week later,” Dahlen says.

Gebeke died Dec. 5.

“I kept thinking I didn’t want this baby, I wanted my mom back,” Dahlen says.

In January, Dahlen suffered a miscarriage. She bled for a month. “It was like a constant reminder,” she says.

“I felt like it was my fault because I was thinking about my mom,” she says. “I was still not connected to the baby because of my mom.”

After the loss, Dahlen didn’t want to do any of the work or projects she’d enjoyed before. She didn’t think she’d ever want to be pregnant again.

The emotional pain of miscarriage – a pregnancy loss before 20 weeks gestation – isn’t always well understood by society, despite its prevalence. Ten to 15 percent of known pregnancies end in miscarriage, according to the March of Dimes.

It’s a grief many hesitate to acknowledge in a death-defying society uncomfortable with the topic, says Aynsley Gunnerson, a funeral director with Hanson-Runsvold, one of two funeral homes that organize a yearly memorial service at Springvale Cemetery for families who’ve lost a child during pregnancy.

“People don’t want to bring it up to them. We don’t want to talk about death, especially with a baby,” Gunnerson says. “It’s not supposed to happen that way. Mom and Dad are supposed to die first. A baby isn’t supposed to die.”

Rebecca’s story

This societal awkwardness with miscarriage causes Rebecca Meidinger of Fargo to pause when someone asks how many children she has.

She says she has four, but that response seems to discount her two pregnancies that ended in miscarriage.

Saying she has six and two are in heaven makes people uncomfortable, she says.

Meidinger miscarried at 6 weeks in 2007, when her oldest daughter was 15 months. Her fifth pregnancy ended in miscarriage in 2011 at 10 weeks.

The first miscarriage was emotionally devastating, she says, even though it happened only a week after her positive pregnancy test.

“In that week’s time you get filled with dreams for you baby and hopes for your baby and excitement,” she says.

The second miscarriage was so horrible physically – she miscarried on the floor of a crowded ER while other waiting patients stared – it delayed her emotional response to the loss, she says.

Meidinger understands the staff was following protocol, but felt she deserved to lose her baby with more dignity.

“They see it as a medical condition, it’s not life-threatening to me,” she says.

But that doesn’t mean a life isn’t lost, she adds.

Working through it

Women who experience miscarriage often have feelings of sadness, anger and a wondering of why, says Heather Bjur, a counselor with Valley Christian Counseling who leads a support group for women experiencing infertility.

Lingering physical reminders and rebalancing hormones also factor in to the grieving process, she says.

How deeply grief is felt depends on the situation, Bjur says, such as whether the pregnancy was unexpected or if the woman has experienced multiple miscarriages while undergoing infertility treatments.

Guilt – “What did I do wrong?” – is another common feeling, says Collette Christoffers, a nurse with Essentia Health who helps lead the local Share Infant and Pregnancy Loss Support Group.

“That guilt is truly misplaced,” Christoffers says.

In cases where the miscarriage happened before the pregnancy was announced, the couple may suffer in silence a hidden loss.

Christoffers and Bjur both say men and women typically grieve a miscarriage differently.

Men often compartmentalize or internalize their sadness, and continue on with daily tasks.

Christoffers says differing grieving styles for men and women can create conflict, “but both are really hurting.”

Research in the May 2010 issue of Pediatrics showed that couples who experience miscarriage were 22 percent more likely to split up than couples who have a successful pregnancy.

Bjur encourages families who’ve experienced miscarriage to talk about it. Support may be found in friends, support groups or online.

“You might be overcome with grief or emotion, but as soon as you’re able to, talk about it. Those things stored up inside us just kind of grow and morph into worse things,” she says.

This is certainly a change from a previous generation, when not just society but the medical community urged women to move on and forget it happened.

“We thought that was best practices, to help moms forget,” Christoffers says.

Older women who come to Share family events (for example, the mother or grandmother of a woman who recently experienced a loss) will thank Christoffers, noting they experienced a loss but never talked about it.

“Thirty to 40 years later, they’re still grieving. They had no opportunity to work through it,” she says.

Acknowledging loss

Life is often divided into before and after a miscarriage, Christoffers says.

“You’ve lost part of your future,” she says. “You always think about what-ifs or what-would-have-beens.”

A common theme Christoffers hears among those who attend Share is they don’t want their baby to be forgotten.

This is why the group has made garden stepping stone markers at its May meeting, releases butterflies and balloons with handwritten messages in August, and each October holds a candlelight memorial service, scheduled this year for 7 p.m. Oct. 15 at Fargo’s First Lutheran Church.

Bjur says it’s important others acknowledge the family’s loss and let them grieve the way they need. A simple “I’m so sorry for your loss” is often sufficient.

Meidinger says comments made by some to comfort her weren’t always helpful, such as “God decided to take your baby.”

“We understand God allows miscarriage to happen, but never that he intends them,” she says. “I think he grieves along with you.”

Worse than the well-meaning but insensitive comments, though, was the silence.

“Most people are silent. That hurts more because your pain should be acknowledged,” she says.

“People don’t know what to do with this topic,” she adds.

She and her husband, Paul, have taken steps to remember their babies they lost to miscarriage.

The first should have been born in June, so they gave their second child the middle name June.

The fifth pregnancy would have been a scheduled C-section, Rebecca says, so she and Paul take time each year on that January date to remember.

Moving forward

With their subsequent pregnancies, Paul and Rebecca waited to set up the nursery, wash baby clothes or buy new outfits.

“We really walked on the side of caution,” she says. “We celebrated. We tried to prepare, but not too much.”

Dahlen is also hesitating to prepare for the baby she and her husband, Marty, are expecting in March. She found out she was pregnant before her previous due date.

“I kind of had to make myself feel like that baby is gone for a reason and you can get another one back,” she says.

Dahlen says she doesn’t feel connected to this baby yet. She worries she could still lose it, and says she will feel better once she can start feeling movement. These weren’t feelings she had when she was pregnant with her son, August, who will be 4 in November.

Christoffers says more anxiety and nervousness is common for pregnancies following miscarriage, especially up to the point of the previous loss.

“These parents are no longer naïve. They’ve experienced the worst of the worst,” Christoffers says.

Both Meidinger and Dahlen say they are thankful they have other children, and recognize miscarriage must be even more difficult for those who don’t.

While Dahlen now understands she did not cause the miscarriage, she says she still feels like she let her mom down by losing the baby.

She does take comfort in her belief that they are together.

“Every time I think of my mom of I think of my baby,” she says.

For more information

The Share Pregnancy and Infant Loss Support Group meets the third Tuesday of the month at Sanford Health Chapel, 1720 University Drive S., Fargo.

A candlelight memorial service will be held at 7 p.m. Oct. 15 at First Lutheran Church, 619 Broadway, Fargo, in honor of Pregnancy and Infant Loss Awareness Month.

For more information, contact Collette at (701) 361-6611 or Michelle at (701) 371-4537.

Readers can reach Forum reporter Sherri Richards at (701) 241-5556