Today marks National Rainbow Baby Day, which takes place annually on Aug. 22 in recognition of babies born after the loss of another child from miscarriage, stillbirth, neonatal death or other infant death. The day signifies hope and healing, giving parents who have experienced the sorrow of losing a child an opportunity to reflect and remember while also celebrating the miraculous new life they were able to bring into the world — a rainbow after the storm.
There are several types of pregnancy loss and no matter the cause, every loss is emotionally devastating. These feelings of intense grief often continue beyond the birth of a healthy subsequent child, despite the joy that brings. Here’s a look at the types of pregnancy loss and tips on how to cope.
Types of pregnancy loss
According to The American College of Obstetricians and Gynecologists (ACOG), early pregnancy loss is common, occurring in about 10 of 100 known pregnancies. Most pregnancy losses happen during the first trimester, often so early that the mother doesn’t even know she is pregnant.
Pregnancy loss includes:
- Miscarriage — Pregnancy loss before 20 weeks gestation.
“Many factors can lead to miscarriage, and it can be difficult to say with certainty what causes a particular miscarriage to occur,” said Amy Wetter, M.D., OBGYN at Northside Women’s Specialists, part of Pediatrix® Medical Group. “As an example, in one-third of miscarriages occurring before eight weeks, there is a pregnancy sac but no embryo inside. This means the egg was fertilized and the cells began to divide, but an embryo did not develop. In other cases, the embryo develops but it is abnormal. Chromosomal abnormalities, in particular, are common. One study found that of more than 8,000 miscarriages, 41%, had chromosomal abnormalities.”
Dr. Wetter said that in some cases, medical conditions in the mother, such as uncontrolled diabetes, or structural problems in the reproductive tract, such as uterine fibroids, can also lead to miscarriage.
- Ectopic (or tubal) pregnancy — The fetus develops outside the uterus, typically in a fallopian tube and, in much rarer cases, the cervix, pelvis or abdomen.
“There is no known cause of ectopic pregnancy, and more than half of women with an ectopic pregnancy will have no risk factors,” said Jill Purdie, M.D., medical director and OBGYN at Northside Women’s Specialists. “According to data from ACOG, after one ectopic pregnancy, a woman has about a 10% risk of another ectopic pregnancy. After two or more ectopic pregnancies, the risk goes up to 25%.
An ectopic pregnancy is not considered viable “since extrauterine locations are not made to accommodate pregnancy, and the fetus cannot grow to the size of viability,” said Dr. Purdie. “The fetus also cannot be moved or reimplanted into the uterus from an external location.”
- Molar pregnancy — The placenta and fetal tissues do not develop normally.
“There are two types of molar pregnancies — complete and partial,” said Sasha Andrews, M.D., maternal-fetal medicine specialist at Obstetrix® of Colorado, part of Pediatrix Medical Group. “A complete molar pregnancy has swollen, cystic-like placental tissue and an embryo is not seen. A partial molar pregnancy can have both normal and abnormal placental tissue, along with a fetus that is not expected to survive after delivery due to chromosomal abnormalities. Both partial and complete molar pregnancies are caused by abnormal fertilization, leading to an imbalance of genetic material from the egg and sperm.”
Molar pregnancies are estimated to occur in approximately 100 per 100,000 pregnancies.
- Stillbirth — The fetus dies in the womb after 20 weeks of pregnancy.
According to the March of Dimes, stillbirth affects about 1 in 160 pregnancies each year in the United States. While we don’t know what causes all stillbirths, common factors include infections, birth defects and pregnancy complications like preeclampsia.
Fortunately, most women who experience pregnancy loss go on to have normal, healthy pregnancies, though the heartache can linger for years.
Coping with pregnancy loss
With pregnancy loss comes a wide range of emotions. “Miscarriage can cause intense feelings of loss,” said Dr. Wetter. “There is no right or wrong way to feel. You and your partner might also experience sadness, anxiety or guilt. Once you become pregnant again after miscarriage, you’ll likely feel joyful and excited, as well as anxious.”
Grief can sometimes be long-lasting, and women who have experienced pregnancy loss are at greater risk for postpartum depression (PPD). “While becoming pregnant again can be a healing experience, anxiety and depression can continue even after the birth of a healthy child,” said Dr. Wetter. “Talk about your feelings and allow yourself to experience them fully. If you are feeling profound sadness or depression and having trouble coping, consult your health care provider or a counselor for support.”
Signs and symptoms of postpartum depression (PPD) include severe mood swings, excessive crying, insomnia and hopelessness. PPD is treated with therapy, medication or a combination of both. To help manage symptoms, Dr. Purdie recommends exercise, which research has shown to improve psychological wellbeing. Asking for help also allows you to step away and take some time for yourself. “Reach out to your family members, friends and other loved ones around you for support.”
Talking about pregnancy loss may be uncomfortable, but it is important for healing. Remember that you are not alone, you are not to blame and there are people who can help.