Processing Loss, Grief, and Trauma After a Miscarriage

In I Had a Miscarriage: A Memoir, a Movement, psychologist Jessica Zucker writes about the lessons she learned from trying to outrun her grief after a pregnancy loss.

[PHOTO: Silhouette profile of woman in front of windows]
In I Had a Miscarriage: A Memoir, a Movement, Jessica Zucker writes about the miscarriage she had at 16 weeks and the #IHadaMiscarriage campaign that resulted from it. Shutterstock

Early in my training en route to becoming a psychologist, I learned that a common reaction to traumatic events is a kind of “perseverance approach.” Referred to in the Diagnostic and Statistical Manual (the go-to guide for mental health) as the “acute stress response,” this is a prime example of the “fight” part of the fight-flight-or-freeze response, which can accompany perceived danger or harmful situations. This physiological reaction to stress is an adaptive mechanism employed with the hopes of shirking danger. I. Must. Survive.

In day-to-day life, this response can take many forms. Sometimes people try on an “I can handle this, I’m okay” attitude in order to push ahead. This is a sincere (and often unconscious) attempt at “moving forward” so as not to sink into the wretched, lonely pit of mourning that so often accompanies trauma. With the loss of a would-be pregnancy, this acute stress response can manifest as anxiety, difficulty concentrating, a sense of impending doom, and/or denial, among other things. We so desperately want to hold on to the life we knew before, untouched by this particular heartache. And so we claw at the walls of our past—comforting walls we knew so well once upon a time. But for so many of us, unavoidably, the profundity of this remarkable experience eventually sets in. And how could it not? We can only stave off pain so long before it comes careening in and shoves its way smack-dab front and center. Trauma has that way about it.

Ready or not, here it comes.

Even as a psychologist, despite knowing what I know from all my years of completing doctoral hoops, barreling through piles of trauma-related textbooks, and talking with other individuals in the midst of their own traumas’ far-reaching reverberations, my post-loss journey was filled with a complicated mix of haphazard attempts at honing that innate survival instinct. Beleaguered and besieged by losing the pregnancy, I focused on putting one foot in front of the other. Day by day. I did my best to continue on. I showed up. I stayed busy. I chimed in. I replied. And on occasion, I smiled, even.

I thought I was okay, but I wasn’t.

Still, I kept moving.

“I’m concerned, Jess. I really feel like you should give yourself more time,” my sister said lovingly but determinedly upon hearing that I was planning to return to work just four days after my miscarriage. Her concern was clear as we spoke on the phone that evening. She knew what I couldn’t seem to surmise on my own: It wasn’t yet time. Of course, it wasn’t. But I was not convinced.

“I feel like I can handle it,” I pushed back gently, in the hopes I might sway her. “Also, I can’t just leave my patients in a lurch. I don’t want them to worry about me, after all. Sitting around isn’t helping ease this pain either.”

[PHOTO: Yellow and purple book cover to 'I Had a Miscarriage']
Courtesy of Feminist Press
If I sat in silence for too long, I could still hear the sound of my own piercing scream as it reverberated off the glass walls of our house. I needed a raison d’être, a purpose, or basically anything that would pull me out of my own poignancy. And I needed it badly.

“It’ll have only been four days.” She repeated herself. “Four days! Your loss happened Thursday; you can’t just return to your office on Monday. You can’t. It makes no sense. Your patients will understand, and it’s best for you and for them that you take a few more days to recover.”

She was right. I knew she was. I just hadn’t given myself the space to really think through not only my options but the potential ramifications of whatever I decided. It was clear that I wasn’t considering my own needs, my recovery, my drained body and mind. And I appreciated her compassionate attention to this very important detail of my life postmiscarriage. What a loving act this was, to care for me when I clearly wasn’t able to do so for myself. So while I dreaded sitting in my grief, and navigating whatever that would inevitably look like, I was forced, through my sister’s grace, to slow down.

“I hear you,” I replied, both scared and relieved that my sister stuck to her guns and saw the light when I couldn’t. “I’ll email my patients now and explain that I’ll return to the office next Monday instead of this coming Monday. And thank you, sis. Thank you for guiding me here.”

Agreeing to slow down did not mean I would stop moving entirely though, and my sister’s concern could not convince me that I didn’t have to remain in a perpetual state of motion. Spending time alone in my head replaying the dreaded details of that day seemed untenable, cruel, even. If I kept moving, maybe the trauma wouldn’t catch up to me and swallow me whole.

I didn’t see it then, and it took me a number of years to properly identify that I had failed to give myself what I needed most in the moments following my pregnancy loss: the space to fall apart. Despite my professional poise, this painstaking grief was unraveling me, slowly but surely, and no amount of driving power to push forward could keep me from eventually crumbling.

Looking back, I realize my attempts to press on were an effort to reinhabit my pre-loss life, as it were. I wanted order, predictability, and peace—the antithesis of the psychological chaos my miscarriage yielded. And in my mind, I could find it all again safely inside my office. Getting back to my patients and those meaningful sessions with them felt like exactly the balm and the rich interaction I’d been craving. I wanted to dive back in—to sit with my patients, and to foster some semblance of regularity. On some level, I probably knew that in the grander scheme, taking only a week and a few days to recover from the physical and emotional trauma of what had occurred was nowhere near enough time, but I needed to reengage—to dive back into my purpose-driven work. This is an act of self-preservation, I told myself. This is the work of rebuilding.

But when I returned to work, it became increasingly clear just how affected I was and how ineffectual my attempts at outrunning my grief had been. Before I returned to sitting in my therapy chair, it didn’t seem concerning to me that my work was inextricably linked to this type of trauma, that the kinds of exercises I had to put my mind through in my office would offer no escape from what was already echoing inside it. Only the week before, I had been able to sit and listen, as my job called for, without having any thoughts about myself. But in a race to sidestep the emotional aftermath of my pregnancy loss, I had sprinted toward a space where loss, grief, trauma, mourning, and the complex ways in which we process it all were discussed at length. I could no longer keep thoughts of my own life siloed from what my patients discussed with me. I had been exposed to the anguish and experiences of my patients’ journeys through very similar traumas. Once again, there was no going back.

From I Had a Miscarriage: A Memoir, a Movement by Jessica Zucker. Used with the permission of the Feminist Press. Copyright © 2021 by Jessica Zucker.