Saying goodbye before you get to say hello
The hardest goodbye is the one you have to say before you even get to say hello.
For many parents on the #ivfrollercoaster, this is a sad reality that stays with you forever.
It is my reality.
For those of us who have had to say goodbye to a loss in-utero, whether this was due to a failed embryo transfer, miscarriage, ectopic pregnancy, termination for medical reasons, or stillbirth, there is a struggle with the ambiguity in such losses. Society in general tends to dismiss an unborn child which often leads to isolation and silence resulting in additional layers of disenfranchised grief (*1) due to lack of acknowledgement and validation of a much-wanted child. Especially if the loss happened before people knew about the pregnancy.
The grief is complex, usually but not always, hidden and fluctuates throughout the life of the parents. It is not just the loss that we grieve, it is also every missed future event, no matter how ordinary or not, that we will never experience.
A research paper states that many people “cannot understand why the grief for a child who has not lived long enough to define himself / herself should be so prolonged or intense.”
Pregnancy / baby loss grief is about the emotional connection of parent to child. A mother is created the instant she has an emotional investment in her pregnancy. Whatever the stage of gestation, the love, the longing, the desire to nourish, nurture, and protect is her emotional investment. For some, this happens long before the actual pregnancy is detected.
Especially in today’s IVF world. Before baby is considered a “real person”, they may be already real to the parent. I heard someone say “I knew my embryo was going to be daughter, how do I pretend she wasn’t real?” Every minute of every process of IVF, from picking up the meds for the cycle to injections, to scans, to egg pickup, to transfer, to waiting, is full of hopes, dreams, and planning for the day we can hold our babies and walk through life with them. Then the excitement of a positive result. Whilst we may be cautious of becoming too excited, for a lot of us, we can’t help being hopeful that this time it is going to work.
Cautious optimism tinged with holding my breath was my norm with every IVF cycle.
Then comes the crash of sad news. It doesn’t matter when this sad news arrives, a few weeks or months, the emotional devastation is immediate and intense. When the pregnancy or birth does not go as planned, we lose not only all our dreams in that instant, but also a future of milestones, events, activities, and memories never to be cherished. The length of the pregnancy is irrelevant to the intensity of sense of loss. As Dr Joanne Cacciatore so beautifully said “the love of a parent is not contingent on the amount of time we had with our child.”
And, therein is the crux of the matter. The love.
We grieve because we have nowhere to give all this love that has already grown in us waiting to be lavished. For those of us who had repeated losses and are now childless, this is even more profound and the sense of longing and emptiness is real and strong.
Research has defined this type of loss as the physical absence of a psychological presence. As the only tangibility would have been in blood tests, scans, and what the mother felt, there is much ambiguity in the experience and memories.
There are many questions around loss, right to grieve, identity and the future. The loss itself – what did I lose? A person? A soul? A mass of fetal tissue? Are others right, I shouldn’t be grieving someone I did not know? Should I forget this pregnancy and move on? Identity – am I a parent, a bereaved parent, or just another person who had bad news? How do I remember and honor myself and this baby? Do I honour and remember or pretend it never happened? Do I have the right to grieve? Is it normal to feel the loss so deeply of an experience I held for such a short time? How do I seek support for what even I can’t express? So many questions. How these questions are explored and addressed has an impact on the grief journey and subsequent integration of grief and loss into a life of love for yourself and your child.
So, how do we muster our strategies to move forward?
1) This type of ambiguous loss (*2) of saying goodbye before we say hello has an important component of tangibility missing leaving some people confused. Working with a therapist to explore and find ways to create a meaningful narrative that tangibilizes the psychological presence of the child as it relates to your grieving style, strengths, and resilience may be a helpful starting point in reducing ambiguity and finding a process for mourning that fits your needs.
2) Enfranchising disenfranchised grief through having your losses validated and your grieving witnessed. Rituals, support groups, being heard in a safe space are some ways that have worked for many in the loss community. Days like International Bereaved Mothers’ Day (*3) help acknowledge mothers who have lost children no matter at which stage.
3) Identity – if you are now childless not by choice but have had losses, you may be asking am I still a parent? How do you see yourself and how do you create a narrative that honours your values, beliefs, sense of self and your child(ren)? These questions may be explored with a therapist, through journaling, support groups, and more.
Please contact me for a ½ hour obligation free conversation if you would like to explore any of the above.
NOTE: There is no right or wrong way to grieve a pregnancy loss. This blog is a personal reflection and spotlights one area of pregnancy / baby loss and its impact on grief, based on the author’s lived experience, study, and conversations within the loss community.
Definitions:
*1 - Disenfranchised grief is when the loss or grieving is not acknowledged or socially supported
*2 - Ambiguous loss is when there is a tangible component missing which inhibits open mourning
*3 - International Bereaved Mothers’ Day falls on the Sunday before traditional Mother’s Day. It was created by Carly Marie Dudley to validate and acknowledge loss mothers while also raising awareness and breaking the silence that surrounds the profound grief of losing a child. It is about honoring the experience of a mother who in society’s eyes may be invisible, especially for the childless not by choice moms.
References:
https://pregnancyafterlosssupport.org/international-bereaved-mothers-day/
Can You Choose Gender With IVF?, Wendy Wisner. 16 April, 2024
https://www.health.com/condition/pregnancy/is-it-actually-possible-to-choose-a-babys-gender-through-ivf
Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief. 2011, Baywood Publishing Co., Inc. doi: 10.2190/OM.63.2.e http://baywood.com
Assisting Clients With Disenfranchised Grief: The Role of a Mental Health Nurse. Journal of Psychosocial Nursing and Mental Health Services. April 2015 DOI: 10.3928/02793695-20150319-05 · Source: PubMed accessed at https://www.researchgate.net/publication/274725506
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