With Pregnancy Loss, Support Is Available

March 17, 2021

When pregnancy loss happens, people often feel alone and isolated. But those who are affected by pregnancy loss do not have to go through the experience feeling emotionally separated from others. Certified nurse midwives (CNM), in addition to tending to a woman's physical health, can offer holistic support during what can be a difficult time.

“We’re really good at providing a safe space for people who are affected by pregnancy loss,” says University Hospitals certified nurse midwife Courtney Steer-Massaro, CNM. “We provide not only emotional support for our patients, but also the medical information and explanation they need. We try to walk our patients through the decision-making processes, depending on how the loss is happening and how they want to manage it.”

Steer-Massaro typically follows up with patients a couple of days after diagnosis to see how they want to proceed, and she checks in a couple of weeks later to see if they need any additional support. For patients who go on to conceive again, she and the CNM team strive to provide extra TLC in subsequent pregnancies of those who have experienced a loss.

Types of Pregnancy Loss

Unfortunately, pregnancy loss is an all-too-common occurrence. In fact, about 15 percent of confirmed pregnancies end in loss, Steer-Massaro says.

There are two main types of pregnancy loss:

A miscarriage, also called early pregnancy loss or spontaneous abortion, happens before 20 weeks. Miscarriages commonly occur in the first trimester. More than half of these losses are caused by chromosomal abnormalities.
A stillbirth is when a fetus dies after 20 weeks. Stillbirths occur in about one of every 100 pregnancies.

Risk Factors for Pregnancy Loss

One of the most challenging aspects of pregnancy loss is that there are often no answers as to why it happened, and that uncertainty can be difficult.

“Women often blame themselves and ask, ‘Is it something I did wrong? Is there something I could’ve done differently?’ That’s not usually the case, though, and I try hard to help my patients understand that,” Steer-Massaro says.

Some factors that can contribute to pregnancy loss include:

Abnormal embryo development
Hormone problems in the mother, such as low levels of progesterone or a thyroid problem
High blood pressure, diabetes or obesity in the mother
Problems in the uterus
Infection
Autoimmune diseases
Injury or trauma
Exposure to toxic substances and chemicals

Remember, most of the time, pregnancy loss can’t be prevented.

Recovery From Pregnancy Loss

The loss of a pregnancy can result in a range of responses, many of which are normal. A woman might feel sad, angry, shocked, or all of the above. Physical symptoms, such as abdominal pain and cramping will likely occur, but the emotional effects can linger after the physical ones resolve.

“Most people recover more quickly physically than they do emotionally,” Steer-Massaro says. Talking with family and friends, as well as simply honoring the loss and the associated emotions are important steps to help manage the grief process.

“Allowing time to grieve the loss is so important,” Steer-Massaro says. “I encourage my patients to give themselves time to go through the grieving process. I also encourage them to remember that everybody recovers differently. If they want to talk with a professional about their loss, I support that decision, too.”

Talking with someone might include a grief counselor, a therapist, or a support group — a patient's doctor can refer them to providers.

When to Try Conceiving Again

In years past, women were often told to wait a certain amount of time before trying to have another baby, but usually that’s not medically necessary. After the HCG pregnancy hormone levels have returned to zero, “you don’t have to wait X amount of months,” Steer-Massaro says. “I tell patients it’s once they’re emotionally ready. They will know when it's the right time for them to think about trying to get pregnant again.”

For people who have experienced two or more pregnancy losses, Steer-Massaro says they could consider testing to see if there is an underlying cause of the losses. But even multiple pregnancy losses do not mean a woman can’t or won’t successfully carry a baby to term.

If a woman does conceive again, it's very common to be anxious as the pregnancy progresses. This is where a good support system, including a compassionate healthcare provider, can be invaluable.

Just remember, Steer-Massaro says: "There is hope — and healing — on the other side of a pregnancy loss."