professional advice needed on miscarriage & divorce?

Question

i should know how to deal with my friend.s miscarriage but i'm just too close to the situation. she miscarried several yrs ago & has another child now. she & husband were fairly happy but something never got healed & theyre having serious marital problems that may stem from that key event. i dont know how to help her, they are separating after a long marriage. theyve had counselling too. i cant seem to help as a friend. anyone go thru this or have advice i can use besides just "being there" for her.

thanks guys so far, but i do counseling, thats part of the problem, i cant help my own friend!

Answer 1

If you want professional advice you should go to a therapist. People that answer stuff here are NOT professional.

Answer 2

Maybe you, as a counselor, can suggest them to try a different counselor. I can see how a miscarriage (but mainly the events in the aftermath of the miscarriage) can damage a marriage. If they are dealing with something that 'never got healed', there is probably some fatigue trying to deal with the problems and that makes counseling even more difficult. I wish when these things happened, there was a way to postpone action and give the situation a 'rest' but that never happens. It's too bad. I guess the only thing you can do is, as you say, 'be there' for her.

Answer 3

Its a bad situation, no one can undestand unless they have been there. I think a lot of problems stem from woman feeling like the man just doesn't care as much. Not that thats true, but men do not let it all out like woman do. When we experience miscarriage its like your life ended for a small amount of time....you are really hurt inside. A man tries to help and understand, but really how can he??? He never carried that child, that child was just a possibility to him...not a reality. Your friend is most likely still carrying that hurt around compounded by the fact she doesn't believe her husband ever cared about or mourned the lose of their child.
She needs to let go.....come to the realization that just because he didn't experience the miscarriage as fully as she did, he was still more than likely hurt, but didn't hold on to it.

Answer 4

Sounds like it is to the point that nothing can hurt the relationship anymore than it has already been hurt. I would suggest sitting the two of them down and saying OK let's take the kid gloves off and find out what the real problem is. Let's start with the miscarriage. Get input from each of them, and then go forward. Sometimes things just need to be aired and faced that have been avoided.

Answer 5

First of all I wouldn't look for professional advice on Yahoo! Answers, you'll mostly get advice and opinions. With that said, she should seek grief counseling. A miscarriage is not her fault and it's not her soon to be ex-husband's fault. It just happens and it's a lot more common than people like to admit.

If she is still grieving then I would suggest counseling, especially grief counseling. As far as her divorce, she needs to work on that one with her husband. I wouldn't get involved.

Answer 6

A miscarriage does not break up a marriage. You know for yourself that it's something deeper then this. I had a miscarriage and I didn't blame anyone, neither did he. We did soon break up, but that was due to other things. If one of them want out, all the therapists in the world can't stop it. Maybe you should step back and watch things and it will come to you to stop talking and just be there for her.

Answer 7

Ask her if she will try relationship counciling. It really helps talking to somebody that is not involved in the situation. It will help them open up to.
If she is in the UK try relate. There are offices and every area and they do not charge it's just donations.
www.relate.org.uk

Answer 8

i've been through miscarriage and even a stillborn child, it isn't that thats breaking up the mariage--that is their excuse, you cannot get involved, they are making a mistake thinking divorce will help them to feel better--what about the child God gave them? isn't she deserving of 2 parents? how ridiculous.

Answer 9

You cannot help your friend because you are too close to the situation. You know that . Try referring her to one of your collegues who can help her professionally with her grief and possible readjustment to her new maritial status.Between 12-15% of pregnancies end in a first trimester, recognizable pregnancy loss. This may be a spontaneous miscarriage or a "missed miscarriage" requiring a D&C. Because this type of loss is so common, it is often underestimated as a source of emotional problems. It may or may not be surprising that rates of depression are reported as high as 22-55% in the year following a miscarriage. Grief, anger, anxiety and panic are also reactions that may accompany pregnancy loss.

There was a good summary review of this problem in a recent article, Broquet K: Psychological reactions to pregnancy loss. Prim Care Update Ob/Gyn 1999; 6:12-16. It points out how a woman feels a sense of oneness with the fetus in early pregnancy and it represents her hopes and dreams. This tends to magnify the loss and when very few support people are aware that a miscarriage has taken place, the usual social customs to recognize the loss are missing.

What are the circumstances that contribute to a strong emotional reaction to an early pregnancy loss?

The greatest contributor to emotional reaction is that a woman looks at the early pregnancy as part of herself and when it is lost, there is an emptiness, searching and incompleteness feeling because the fetus is not viewed as a separate being. Also, the connection to the fetus is much stronger for the woman than for her partner and there is a great difference in the intensity of the grieving process between the mother and father. A woman becomes isolated because of this and often has no emotional support for her feelings. Even the usual social rituals of a death notice, a funeral, and friends offering sympathy are absent because very few people usually know of the event. This prevents accepting the reality of the loss. If there was any ambivalence about the pregnancy in the first place guilt becomes a major component of the grieving process.

What tasks are necessary to resolve the grief of a pregnancy loss?
Workers is this field have identified four tasks to be accomplished to work through the grieving process in a psychologically constructive way. The general time it takes is as much as 12-18 months after the loss.

Accept the reality of the loss -- if the miscarriage takes place before friends and family know of the pregnancy, sharing the loss with others may help or even some sort of commemorative steps either public or private. If the pregnancy loss is further along, a burial ceremony or even just holding the fetus can help.
Allow experiencing the pain of grief -- if the grieving process is suppressed, it is more likely to result in psychological reactions. The woman needs to consciously grieve for lost dreams. This process will wax and wane but should not be suppressed by drugs, alcohol or even the rapid attempt to become pregnant again so as to relieve the pain more quickly.
Adjust to the new situation without the lost child -- a woman must change her perception that part of herself is lost. She needs to resume her role and self-identity at least as it was prior to becoming pregnant.
Reinvest emotional energy in new relationships -- a woman recovers and benefits from building new ties and nourishing the relationships already present.

What are the psychiatric consequences of pregnancy loss if the grief process does not progress to resolution?
The most common problems are depression and anxiety. The general rate of depression in women is about 10-15%. After miscarriage, this rate is reported to be 22-55% and takes 12 months to return to the baseline rate of depression in the general community. The highest risk time for depression is the first 12 weeks after a pregnancy loss. Risk factors for developing clinical depression include previous depression, the further along in pregnancy that the loss occurred, a history of substance or alcohol abuse, a poor support system and a history of poor coping skills.

Community rates of generalized anxiety or panic disorder are about 3-5% in women. In the first 12 weeks after a pregnancy loss, 22-41% of women demonstrate these problems. As with depression these rates tend to return to baseline community rates within 12 months. Compulsive behaviors may increase during this time. Women who have had previous pregnancy loss are at greater risk of developing depression and anxiety in subsequent pregnancies.

How do you know if the emotional reactions are just normal grief or if they have gone into a full depression?
Sadness, mild depression, guilt, anger, fatigue and somatic complaints are common to both grief and to a clinical depression. Grief will result more in disbelief, feelings of failure as a woman, and searching for meaning or the loss, while major depression has strong feelings of worthlessness, early morning awakening and persistent suicidal thoughts. Specific symptoms that require medical intervention include:

serious or persistent suicidal thoughts
significant feelings of worthlessness
terminal insomnia - falling asleep ok but awakening predawn with increased anxiety or abnormal fear
significant physical listlessness or agitation
marked daily functioning difficulty - not eating, not bathing, unable to work or care for children
prolonged symptoms (greater than one year)
drug or alcohol abuse or significant increase in use

Is the emotional reaction to an induced abortion the same as it is to a miscarriage?
In general, the rate of emotional problems after elective abortion are no greater than that of the general population unless there has been a previous history of depression or if the woman feels she was coerced into the abortion or that it was morally wrong. In those cases, emotional problems follow the same rate as an unexpected pregnancy loss.

What can be done to help a woman who is having an emotional reaction to a pregnancy loss?
Certain interventions have been shown to reduce the rate of psychologic problems after a pregnancy loss. The best preventative is a "crisis debriefing" within the first 2-3 weeks after the miscarriage. This would include giving a woman an opportunity to discuss her feelings about what happened and making sure she has the correct factual information such as "it was not due to anything you did or did not do". Also, resources for emotional support should be identified at that time and if there are not many within the existing family or social structure, referring to support groups and recommending reading materials on common reactions to miscarriage and grief. There also should be some ongoing monitoring for depression or anxiety reactions in the next year to make sure the process is resolving.

Some additional interventions are:

Acknowledge the loss and educate the woman about the natural grief response
Encourage use of family, friends and support groups
Provide reading materials
Encourage expression of feelings, including anger, in a nondestructive manner
Address guilt with reassurance about reasons for loss and future fertility
Ask directly about suicidal thoughts
Monitor for excessive anxiety, depression, substance or alcohol use/abuse and refer if present
Monitor for marital discord which is common after a pregnancy loss
Monitor for depression, anxiety, or grieving in subsequent pregnancy

Major Support Group
SHARE (Source of Help in Airing and Resolving Experiences)
Support group for parents grieving the loss of a baby through miscarriage, ectopic pregnancy, stillbirth or early neonatal death.

National SHARE Office
St. Joseph Health Center
300 1st Capitol Drive
St. Charles, MO 63301-2893