Introduction
You were nine weeks. You’d told almost nobody, because that’s the rule, so almost nobody knows there’s anything to be sad about.
On Monday you went back to work. Somebody asked how your weekend was and you said fine, thanks, and asked about theirs. There was a scan photo on your phone that you couldn’t look at and couldn’t delete. Your mother said at least it was early. Your best friend, who meant only kindness, said at least you know you can fall pregnant.
And you have been walking around ever since with a grief that nobody has acknowledged, wondering whether you’re allowed to be this broken about it.
You are. Let’s start there.
How Common, and How Little Said
Miscarriage ends roughly 15% of recognised pregnancies. Worldwide that comes to around 23 million a year, which works out at something like 44 every minute.
Which means this is happening constantly, to people you know, in near silence. The convention of saying nothing until twelve weeks was meant to protect women from having to un-announce a pregnancy. What it often does instead is guarantee that when the worst happens, you grieve it alone, among colleagues and friends who never knew there was anything to lose.
Grief like this has a name in the literature: disenfranchised grief. It’s the grief that society doesn’t quite recognise, so no leave is offered, no one brings a casserole, and there’s no funeral to give the loss a shape. The pain is ordinary. The silence around it is what makes it so lonely.
This Is Not Only Sadness
People expect to feel sad. Many women are caught off guard by everything else.
One study followed nearly 500 women after a miscarriage or ectopic pregnancy. A month afterwards, 29% met the criteria for post-traumatic stress, 24% for anxiety and 11% for depression. Nine months on, 18% still had post-traumatic stress symptoms.
That makes sense once you remember what actually happens in a miscarriage. There’s often bleeding, pain, fear, an emergency room, a scan room with no heartbeat on the screen, a procedure, sometimes a long wait in a corridor with pregnant women. It can be a frightening physical event as well as a loss, and the body remembers it that way.
So if you’re having flashbacks to the bathroom floor, or you can’t drive past the hospital, or you jump at the smell of the hand sanitiser they used, that isn’t weakness or drama. It’s what trauma does, and it responds to treatment.
The First Few Weeks
Coping with miscarriage in the short term is partly a physical matter, and people are rarely warned about that side of it.
There can be bleeding and cramping for a week or two, and hormones that take time to settle, which is its own emotional weather independent of grief. Some women get a few days of feeling almost normal and then a hard drop. Follow whatever your doctor has told you about rest, bleeding and when to call, and go back if something doesn’t feel right.
As for work: be careful about returning too quickly simply because nobody knows and it seems easier to carry on. If you can take a few days, take them. If you need to tell one person at work so that somebody understands why you’ve gone quiet, that is a reasonable thing to do, and you are not obliged to explain it to anybody else.
The Guilt That Makes No Sense
Almost every woman I see after a miscarriage has a private theory about what she did.
The glass of wine before she knew. The deadline she worked through. The gym session. The row she had. The fact that she wasn’t sure she wanted to be pregnant in the first week, and then was, and then this.
Most miscarriages happen because of chromosomal problems in the pregnancy itself, and nothing anyone did or didn’t do changes that. Your doctor can speak to your specific circumstances, and it’s worth asking directly rather than carrying a theory for years.
Knowing it isn’t your fault and feeling it are different things, though, and the gap between them is where the guilt lives. If you notice that you are far harder on yourself than you would be on anyone else in exactly your position, that’s worth taking seriously.
Two People, Two Griefs
Partners get forgotten here, and often agree to be forgotten.
The person who wasn’t pregnant frequently decides, silently, that their job is to hold everything together: handle the admin, manage the family, be fine. They go back to work, and nobody asks them anything at all. Their grief then arrives late, often months later, and usually with some confusion about whether they’re entitled to it.
Couples also tend to grieve at different speeds and in different registers. One wants to talk about it every night; the other wants an evening where it isn’t mentioned. One wants to try again immediately; the other cannot contemplate it. Each reads the other as not caring, or as caring too much, and the strain it puts on a relationship can outlast the loss itself.
Saying it out loud helps more than people expect. “I need to talk about her tonight.” “I can’t tonight, but I can tomorrow.” Neither of you is wrong. You’re grieving at different speeds.
The Children Who Were Waiting Too
If you already have children who knew, they’ve lost something as well, and they take their cue from you.
Keep it simple and true. The baby was not strong enough to keep growing, it isn’t anybody’s fault, and Mom and Dad are sad, which is allowed. Avoid “we lost the baby”, which small children take literally and may try to help you look for.
Children often ask the same question repeatedly over weeks. That’s not morbidity; that’s how they digest things. A family carrying something it can’t talk about does worse than a family that says the hard thing plainly.
What Helps, and What Doesn’t
Let people love you badly. Most of the awful sentences come from people who care and are frightened of saying nothing. You can let the clumsiness go without pretending it didn’t sting.
Name the pregnancy if you want to, or mark it somehow. A plant, a bracelet, a date in the diary, something at the beach. Grief with no ritual tends to go underground, and a small ritual of your own making does a surprising amount.
Expect the dates to arrive with force: the due date especially, and the anniversary. Put them in your diary rather than being ambushed by them, and plan something soft for the day.
Be careful with social media for a while. Nothing is crueller than an algorithm that has worked out you were pregnant.
And if you try again, know that the next pregnancy is often anxious rather than joyful, right up to and past the point where you lost the last one. That’s normal, it’s exhausting, and it’s worth having support lined up in advance rather than white-knuckling the first trimester.
If You Want to Help Someone Else
You may be reading this because it happened to your sister, or someone at work, and you are frightened of saying the wrong thing.
Skip anything that starts with “at least”. At least it was early, at least you know you can fall pregnant, at least you have one already. Each of those is an argument for why the person should feel better, and none of them has ever worked.
What does work is short and unclever. “I’m so sorry. I’m here.” Then say the pregnancy existed, because most people won’t, and the silence is the lonely part. Bring food. Offer something specific rather than the open-ended anything-you-need, which puts the work back on them: a lift, a supper on Thursday, an hour with the older children.
Then remember the dates, and check in again in three months, when everybody else has moved on. That’s the call people will remember for years.
When to Ask for Help
There’s no schedule for grief, and anyone who tells you there is has not had this happen to them.
That said, reach out if you’re still unable to function after a few months, if you’re having flashbacks or nightmares, if you’re avoiding anything that reminds you of it, if you’re drinking more to get through the evenings, or if the sadness has flattened into something that feels like nothing at all. The researchers behind that study recommended screening women about three months after a loss, which tells you how routinely this gets missed.
SADAG offers free telephonic counselling on 0800 20 50 26 from 8am to 8pm daily, and their 24-hour suicide crisis line is 0800 567 567. If you ever feel you don’t want to be here, please use it.
If It Happens More Than Once
Recurrent loss is its own particular cruelty, and the grief compounds rather than adding up neatly.
It’s less common than a single miscarriage. Roughly 2% of women have had two or more losses, and fewer than 1% have had three or more. If that’s you, ask your doctor about investigations, because at that point there are tests worth doing and some causes that can be treated.
Worth holding onto, while you decide what to do next: even after recurrent loss, the chances of a future successful pregnancy remain good for most people. That isn’t a reason to rush, and it isn’t a promise. It’s just a counterweight to the certainty that tends to settle in after the second one.
How Therapy Helps
Some of it is simply having one hour a week where the pregnancy existed and you don’t have to manage anybody else’s discomfort about it. That alone is worth a great deal when the rest of your life has moved on without acknowledgement.
Where there’s trauma, the work is different from grief work: we go at the memory carefully, so that your body stops treating a scan room as an emergency. Where there’s guilt, we take the private theory out and look at it properly in daylight. And where a couple has got stuck in two separate griefs, working on it together usually helps more than either of you doing it alone.
Conclusion
A pregnancy that ends early was still a future you were already living in: the room you’d mentally rearranged, the names you’d half-chosen, the way you’d worked out how to tell your parents. Losing that is a real loss, whatever anybody else manages to say about it.
You don’t have to be over it by now, and you don’t have to grieve it quietly because nobody knew.
I offer bereavement and pregnancy loss support when you need it, in person in Claremont (close to Rondebosch, Newlands, Kenilworth and Wynberg) and online across South Africa.
It counted. So does this.
<h3> About Me
I’m Paula Marais, a registered specialist wellness counsellor based in Claremont, Cape Town. I hold an Honours in Psychology (Unisa) and a Master’s in Creative Writing (UCT), and I’m registered with the Association for Supportive Counsellors and Holistic Practitioners (ASCHP).
I offer individual and couples counselling, in person in Claremont and online across South Africa. Online sessions are equally as effective as in-person sessions.
There’s no pressure and no judgment. You can reach me at info@paulamaraistherapy.com or on WhatsApp at 072 633 7661.
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