“I ended a wanted pregnancy for medical reasons and I can't grieve it out loud”
Ending a wanted pregnancy after a scan or test shows a serious problem often happens fast: a diagnosis, a few days of decisions, a hospital procedure. Many tell people it was a miscarriage, or tell no one, because the word abortion brings judgment they can't face while grieving. The grief can include a named baby, a due date, and the weight of having made the choice. In a study of 62 women after a second- or third-trimester termination for fetal anomaly (Kersting and colleagues, Archives of Women's Mental Health, 2009), 16.7% had a psychiatric disorder 14 months later, compared with 7.1% of women after a preterm birth and none after a healthy birth.
What to check first
It helps to check physical recovery first, including bleeding, pain, milk coming in and hormone changes, which a doctor or midwife can look at. It also helps to notice who knows the full story, if anyone, and whether a partner is grieving too. Some support groups are only for people who ended a pregnancy for medical reasons.
What could be going on
Grief after miscarriage, stillbirth or neonatal death: Fits if you are grieving a baby and the future you had already pictured.
Grief (complicated, disenfranchised, anticipatory): Check whether the grief feels unallowed because you made the decision, or because so few people know.
Bereavement guilt and regret (Li and Stroebe): Fits if you keep going back over the decision, the tests and the day itself.
Shame: Check whether you are hiding what happened for fear of how others will judge it.
Telling them apart
Grief after miscarriage, stillbirth or neonatal death: The grief may be for a baby who was wanted and already part of the family's plans: the scan photo, the name, the nursery. Dates like the due date tend to bring new waves. The loss is real whatever the medical route.
Grief (complicated, disenfranchised, anticipatory): The grief may go unrecognized because of how the pregnancy ended. Some people may treat it as a choice that needs no mourning, or as a subject to avoid. Grief that others won't acknowledge is often called disenfranchised.
Bereavement guilt and regret (Li and Stroebe): The mind may go back over the decision again and again: the tests, the odds, the doctor's words, whether another choice was possible. Relief that the baby will not suffer may sit beside guilt for choosing. Both can be there at once.
Shame: The parent may hide the story because of public arguments about abortion, or fear of a relative's views. The shame may attach to the self as well as the decision. Hiding it can cut the parent off from the people who might help.
Questions to carry
- The last time I wanted to say what happened and didn't, who was I with?
- What did I lose, in my own words, that I haven't been able to say?
Also said as
- tfmr grief
- termination for medical reasons and no one knows
- we ended the pregnancy after a fatal diagnosis
- grieving a baby i chose to let go
- can i grieve an abortion i didn't want
- told people it was a miscarriage