Can You Have Postpartum Depression After a Miscarriage?

Having a miscarriage is physically and emotionally difficult under any circumstance. Indeed, "in a national survey that we completed, one in five people reported that the emotional loss following a miscarriage was similar to that of losing an older child," explains Dr. Zev Williams, M.D., director of the Program for Early and Recurrent Pregnancy Loss (PEARL) at Montefiore Medical Center/Albert Einstein College of Medicine in New York. Some people developed postpartum depression after miscarriage.

Though time and comfort are often the best healers, it helps sometimes to understand the mourning process that can accompany a miscarriage and know what you can do to start coping with pregnancy loss. Here's how to begin.

What Are Some Common Feelings After a Miscarriage?

Many expectant parents form an attachment to their baby early in pregnancy. So after a miscarriage, they're likely to go through a period of mourning. Some experience the same stages of grief that accompany the death of an older loved one. These stages are:

1. Denial: A refusal to believe what has happened
2. Anger: Blaming yourself or others for the loss
3. Bargaining: Striking a deal with yourself or God to have things return to the way they were
4. Depression: Feeling listless, tired, despondent, guilty, punished, and/or as if there's no pleasure or joy in life
5. Acceptance: Realizing that life has to go on, and regaining your energy and goals for the future. This stage involves learning to live with your loss

Can You Have Postpartum Depression After a Miscarriage?

During the mourning period, emotions may be thrown into turmoil. If the expectant parent has been trying hard to conceive, they may mourn the child lost as well as the fact that they're no longer pregnant. If they've suffered more than one miscarriage, they may be saddened by the fact that they have been unable to carry a pregnancy to term.

Some may develop a form of postpartum depression after miscarriage. Symptoms include intense sadness, emptiness, anger, irritability, fatigue, guilt, worthlessness, and jealousy of those who are pregnant. Postpartum depression is especially possible if these symptoms last for more than a few weeks. It can also affect individuals indiscriminately. People of all sexes and gender identities can (and have) struggled with postpartum depression.

If you're having trouble dealing with these emotions, speak with your doctor, who can refer you to a counselor if necessary. Some cases of postpartum depression may need treatment with antidepressant medications, talk therapy, or behavioral methods like cognitive behavioral therapy.

What Are the Best Ways to Cope with Miscarriage?

Grief and mourning can last anywhere from less than a month to a year or more, depending on the circumstances of the miscarriage. Initially, the feelings may be intense and all-encompassing. But over time, they may begin to ease up, giving way to periods of relative calm, well-being, and, eventually, acceptance.

Though there's nothing you can do to "rush" the mourning process, there are simple ways you can take care of yourself as you heal.

Ask for help in breaking the news. If you're feeling too fragile to talk about your miscarriage or to deal with other people's reactions, ask a friend, relative, or coworker to tell others so you don't have to discuss it.

Don't take hurtful comments to heart. Many people don't realize how profound a loss miscarriage is and may say things like "Don't worry, you can always try again." More often than not, though, people don't mean to be insensitive—they're just unaware of how you're feeling and can't fully comprehend your pain.

Help others understand. If you feel up to it, educate the important people in your life about pregnancy loss. Suggest, for instance, that they read a book on the subject, such as A Silent Sorrow—Pregnancy Loss: Guidance and Support for You and Your Family by Ingrid Kohn, Perry-Lynn Moffitt, and Isabelle A. Wilkins (Routledge).

Don't apologize for your pain. During your healing process, friends and relatives may pressure you to "move on," "get over things," or "return to life as usual." But don't feel as though you need to comply until you're ready. Your pain is a normal response to the profound loss you've suffered, and you needn't blame yourself or apologize to anyone for how you feel.

Seek support. After a miscarriage, it may help to talk with someone who's been through the same experience, or to join a support group that meets regularly. SHARE, a national organization for couples who've experienced miscarriage, may be able to put you in touch with a support group in your area.

Ask for household help. As you recover from a miscarriage, ask friends and relatives to help with household chores, like laundry, errands, or cooking. You'll need time to physically and emotionally heal, and it can help to lighten some of your day-to-day responsibilities.

Be mindful of your feelings. Immediately after a miscarriage, you may find it hard to be around friends and relatives who are pregnant or have babies. If it feels too painful to see them, give yourself permission not to visit. Tell them that you still hold them dear, but that this is a difficult time for you and it's just too hard to see them now. Also, think about how you feel before accepting any invitations to a baby shower, baptism, or first birthday party.

Think about anniversaries and holidays. Anniversaries, such as the date the pregnancy was lost or the due date, may also be painful, and you may feel sadder than usual at these times. If you need to, take the day off, attend a religious service, or mark the date in some special way. Holidays may be difficult after a miscarriage too. If you're grieving, think about quietly observing the holiday at home or attending festivities only briefly.

Consider the future. If you and your partner have been through more than one miscarriage, you might begin thinking about alternatives. To start, consider scheduling an evaluation with your OB-GYN to discuss possible diagnoses that might cause recurrent miscarriage. For some people, having multiple miscarriages doesn't mean you can never carry a child.