When the Heart Breaks: Psychiatric Support for Miscarriage Grief

According to data from the Hong Kong Department of Health, between 2018 and 2020, there were nearly 15,000 cases of miscarriage each year. Approximately one in five pregnant women experiences a miscarriage. Yet, in Hong Kong, miscarriage is often seen as an "unacknowledged grief," leading many women to avoid discussing their loss. Miscarriage not only signifies the loss of a baby but also the loss of the opportunity to experience pregnancy and childbirth, the dream of becoming a mother, and the hope of building a family. For women who have worked hard to conceive, the joy of pregnancy followed by the heartbreak of loss can be especially devastating.

Causes of Miscarriage

Miscarriage, or spontaneous abortion, refers to the termination of pregnancy before 20 weeks gestation due to various factors that prevent the foetus from continuing to develop. Common causes include chromosomal abnormalities in the embryo, polycystic ovary syndrome (PCOS), uterine structural abnormalities, infections, and chronic medical conditions. Additionally, unhealthy lifestyle habits such as smoking, alcoholism, overweight, or advanced maternal age can increase the risk of miscarriage.

Emotional Distress After Miscarriage

Loss and Grief: Unspeakable Emotions

From the moment a new life begins to grow within, a bond forms between the mother and her unborn child. Even if the pregnancy is brief, this connection often feels profound to many women. When a miscarriage occurs, it brings not only physical pain but also a significant psychological wound.

This sense of loss is often likened to "invisible mourning." While it resembles the grief of losing a loved one, society often fails to acknowledge or understand the pain of miscarriage. Some women may feel immense sadness, even blaming themselves: "Did I do something wrong?" or "Did I fail to care for the baby properly?" These thoughts, though common, are not grounded in truth. Most miscarriages occur naturally and are not related to the mother’s behaviours.

Unspoken Pain: The Weight of Repressed Emotions

The experience of miscarriage is often hard to talk about due to fears of being misunderstood or even encountering indifference or inappropriate comfort. A study conducted by the Hong Kong Jockey Club on public attitudes towards miscarriage found that common remarks meant to comfort grieving parents include: "You’re still young; you’ll have another chance to conceive," or "At least you have other loved ones." While well-meaning, such words can make women feel that their grief is disregarded. Some individuals worry that sharing their pain will leave friends and family feeling awkward or helpless, so they choose to stay silent. This internalisation of pain can hinder the healing process. When comforting parents who have experienced miscarriage, use gentle and empathetic language, such as, "Your child knows they were loved," "It’s normal to feel sad," or "Take all the time you need to heal." Provide proactive and heartfelt support, accompanying them through their loss and sorrow.

Returning to Work Immediately: The Clash Between Emotion and Reality

Many women have little time to heal physically or emotionally after a miscarriage before returning to work. Outwardly, they may appear to have resumed normalcy, but internally, they may still be struggling with overwhelming grief. At the workplace, no one may know about the silent farewell they’ve endured. Suppressing such emotions can lead to anxiety, excessive stress, and long-term mental health challenges.

How to Cope with Emotional Trauma After Miscarriage

While everyone’s healing journey is unique, the following suggestions may help women navigate this difficult period:

Allow Yourself to Grieve: It is natural to feel sorrow over the loss of a new life. Give yourself time to process and adjust, rather than pressuring yourself to "move on quickly."
Hold a Memorial for Your Baby: The government has established " Garden of Forever Love," the first facility for laying foetal remains to rest. Bereaved parents can place flowers, hang messages, or install plaques to commemorate their child.
Post-Miscarriage Recovery: After a miscarriage, women often experience significant physical depletion and require proper care to recover. Women who miscarry before 12 weeks may benefit from 1–2 weeks of rest, while those who miscarry between 12–20 weeks may need about three weeks. Adequate rest not only aids physical recovery but also offers a sense of ritual, which can help with emotional healing and prepare the body for future pregnancies.
Seek Support: Share your feelings with trusted friends, your partner, or a mental health professional to release your inner pain.
Express Your Emotions: Writing a journal, drawing, or even penning a letter to your unborn child can be a therapeutic way to release emotions.
Take Care of Your Physical and Mental Health: Adequate rest, a balanced diet, and gentle exercise can support both physical and emotional recovery.
Connect with Others Who Have Similar Experiences: Joining support groups or connecting with women who have gone through similar experiences can remind you that you are not alone.

Conclusion

The pain of miscarriage is real and should not be ignored or dismissed. Every woman who has endured this journey deserves understanding and support. We hope for a future where society offers greater compassion and openness to the topic of miscarriage, so women no longer have to face this silent grief alone. If you or someone you know is struggling with the pain of miscarriage, remember that you are not alone. Allow yourself the time and space to heal.

Should you have questions about managing your emotions or find yourself overwhelmed by grief, do not hesitate to seek help. Our family doctors or psychiatrists are here to provide professional advice and support, helping you improve emotional well-being and move towards a brighter future.