All Loss Is Not The Same: Working with Couples Coping with Infertility, Pregnancy Loss, and the Unexpected Results of Genetic Testing
While our responses to loss have common features, not all loss is the same nor is all loss recognized in the same way. For those who struggle with infertility, pregnancy loss, and the unexpected results of genetic testing, grief is layered and complex. It is often unseen or marginalized by others, making the grieving process all the more difficult. Couples who experience these types of losses are mourning multiple events. And clinicians need to be aware of these losses in order to help clients mourn and move toward healing.
The disappointments caused by these losses are often overlooked. When we encounter infertility, for example, we tend to think of the couple’s inability to conceive and do not see other hidden pain they experience. Few people recognize the full impact of the sadness that the infertile couple is going through. The loss of a hoped-for future is one of the complex layers felt by the couple experiencing infertility. It can be very difficult to allow oneself to grieve over something that has not come into full existence, as is the case with the dream of having a life with children.
Couples who have gone through a pregnancy loss or the unexpected results of genetic testing, suffer the loss of the future in a way that is different from the struggle of those experiencing infertility. Every couple has a vision of their baby and the life they are going to have with him or her. And when that is lost, the pain is crushing while the loss is often mourned in silence. Grief then turns invisible, unacknowledged even by well-meaning others who respond with such comments as “you can have another” or “it’s not your fault.” Or in such cases as multiples where one twin is lost, people might attempt to console with, “at least you have one baby.”
The number of these experiences is not negligibly small; of course, even if it was, sufferings that are rare are harrowing or isolating in a special way. But most of the invisible losses we have in mind here are common. To take just one type of loss, today as many as 20% of clinically diagnosed pregnancies will end in a miscarriage. Despite this high number, these experiences are not widely announced or shared. Even the tendency of today's social media to share, and even overshare, life events and updates does not usually extend to these kinds of hardships
What does this mean for our clients who experience invisible losses and are suffering in silence? We need to remember that these clients walk into our office carrying the heartache of days, months and sometimes years of cumulative loss. They are mourning—over and over. It is our task to witness and help them express the roller coaster of emotions that they are experiencing. Our clients need to feel their way through the losses and over time, fold them into their lives—finding a “new normal” and creating an expanded life narrative.
We need to ask ourselves, how comfortable are we giving a name, a story, and a voice to their pain? If we, ourselves, can get comfortable with and take seriously the losses of our clients, we can then make the gentle inquiries into the invisible and unspoken worlds of infertility, pregnancy loss, and unexpected genetic diagnosis. Through sharing their heartache with us, with their partners, and with trusted loved ones, our clients will eventually heal and move forward with a “new normal” in place. When we help our clients bring loss out of invisibility and silence, we help them live their lives out of the shadows feeling loved, accepted and supported by those around them. While the human lens toward the world is forever reshaped by a loss, the experience of joy can be recovered and even increased. Their stories have been validated and honored, and they can once again live meaningfully and fully.