Although miscarriage is very common, it can feel difficult to talk about. Up to 20% of known pregnancies end in loss, yet many who’ve been through it still describe a sense of shame and stigma around the experience.
It may feel even more uncomfortable to address miscarriage with children. If your child knows he or she is getting a new sibling and then that changes, you may be left wondering how to break the news or if you even should.
“Although very painful and difficult, it is important for parents to take the step of explaining pregnancy loss to their children because even at a very young age, children can pick up on others’ emotions,” said Becky Stuempfig, a licensed marriage and family therapist.
“They are likely sensing that their parents are sad even if parents think they are ‘acting normal’ while with their child. They may overhear conversations and wonder what is going on, but feel fearful of asking or not know how to ask in the case of young children,” she added. “Neurologically our brains want to make sense of what is happening around us, so if parents don’t explain pregnancy loss, children will begin to come up with their own explanation.”
As a parent, you can help your child understand pregnancy loss and the emotions it evokes. But how exactly should you approach conversations about miscarriage with kids? Below, Stuempfig and other experts share their advice.
Make sure you’re ready.
“As the common saying goes, you must put your own oxygen mask on before administering someone else’s,” said Jessica Zucker, a psychologist specializing in reproductive and maternal mental health and the author of “I HAD A MISCARRIAGE: A Memoir, a Movement.”
“Children pick up on and often rely on their parent’s emotions to help them form their responses to situations, so it’s most helpful to make sure you’re in a headspace that will best allow you to guide your child through their own process as they digest the discussion,” she noted.
Take some time to process your own feelings before talking to your child. Choose to start the conversation at a time when you feel calm and are available to talk for a long time in case they have lots of questions.
“It can be helpful for parents to have the discussion together with their child so that partners can feel supported by one another and if one partner becomes flooded with emotion, the other partner can take over the discussion,” Stuempfig said. “It’s okay for a child to see parents grieve, but it is important that parents are emotionally available to the child during the conversation and not so overcome with their own emotion that they are unable to attend to their child.”
Be honest and direct.
“When parents are faced with explaining pregnancy loss to a child, they should keep the conversation honest and simple,” Stuempfig said. “When you are dealing with children and grief, it is best to provide a small amount of information in a concise way and then check in with the child to see if they have questions.”
Don’t get too bogged down in complicated details or say unnecessary extra words. Let their specific questions guide the discussion and keep it simple with straightforward answers. You can turn to children’s books to help explain loss and grief.
“The best way to go about it is to be as direct and factual as possible within the appropriate developmental stage of the child,” said Jenny Yip, a clinical psychologist and author.
Tailor the discussion to your child.
Take your child’s age, developmental level and temperament into account when you share your pregnancy loss. With toddlers and preschoolers, avoid euphemisms or terms they won’t understand, like “passing away” or “going to the great beyond.”
“Young children take everything literally, so parents should avoid saying things like ‘we lost the baby’ because they might start worrying that their parents will lose them too,” Stuempfig said. “An honest explanation can be easier for children to comprehend, such as ‘We don’t know why this happened. Sometimes babies are born healthy like you were and sometimes it doesn’t happen that way and the baby isn’t born.’”
Prepare to have to explain it to your child multiple times and try not to shut the conversation down if they bring it up again.
“The concept of pregnancy can be very hard to understand, and this makes explaining the loss even harder for children,” said Perri Shaw Borish, a licensed clinical social worker who specializes in maternal mental health. “For a younger child, provide small amounts of information at a time and answer their specific questions. For an older child, you can tell them that the baby was not strong enough to live outside the mommy’s belly, and that means that the baby died.”
For even older kids, there may be an interest in the science of the human body and reproductive health. You can talk about the scientific details of reproduction, complications that can arise and chromosomal abnormalities.
Make it clear it’s no one’s fault.
“Much like conversations centering around divorce or a parent separation, it’s common for children to immediately blame themselves for a pregnancy or infant loss,” Zucker noted. “This is primarily due to their cognitive development, which leaves them centering themselves or only seeing things through their perspectives. So it’s vital that throughout the conversation, and perhaps even at the start, you remind your child that they are in no way responsible for any pregnancy outcome, especially one that ends in a loss. And that it’s not the fault of the mom either.”
Emphasize that it’s nobody’s fault, just something sad that happened. If your child asks why the loss happened, you can explain that miscarriage is rather common and often due to abnormalities out of our control, not the result of anything anyone did or didn’t do.
“Above all, let your children know that you love them, and that you are pleased they are in your life,” said Catherine Athans, a licensed marriage and family therapist. “Hugging and kissing go a long way to make your child or children feel safe!”
Talk about your feelings.
“After a miscarriage, the emotional reaction from parents ranges anywhere from ambivalence to anger to complete despair,” said Misty Richards, program director for the UCLA Semel Institute’s Child and Adolescent Psychiatry Fellowship. “Often times, this manifests in bouts of crying, wanting to be alone, and quiet moments of reflection that can be witnessed by a child. Rather than hide this emotional response, help your child understand what they are seeing by naming the emotion ― ‘Mommy was crying a little bit because I am sad about the baby.’”
When you name the emotion and the reason why, your child learns how to identify feelings and also hears the message that it’s normal to feel sad and cry sometimes. It’s also useful to let them know that even though you feel sad sometimes, you’re going to be OK. Parents should model vulnerability and healthy coping skills, like taking breaks, asking for help and sharing their feelings. Ask your child for a hug if you need one.
“Learning to talk about and process losses together as a family is a critical skill that a child can take with them into adulthood and draw upon for the rest of their lives,” said Neha Chaudhary, a child and adolescent psychiatrist at Massachusetts General Hospital and Harvard Medical School. “The more we talk to kids about tough topics like pregnancy loss, the more we can model what it means to experience the hard parts of life and navigate big feelings together, head-on.”
Validate their emotional response.
Just as you open up about your emotions, invite your children to do the same. Ask them what they’re thinking and feeling during the conversation and check in days later to see if that changes as they’ve processed the information.
“Encourage kids to ask questions, draw pictures or write a letter and express their feelings,” said Sheryl Ziegler, a psychologist, play therapist and the author of “Mommy Burnout”. Playtime is another area where their emotional response may manifest, so pay attention to the words and themes they use.
Depending on your culture, you may engage in grief rituals following a pregnancy loss. Invite your child to participate.
“With pregnancy loss, parents can ask even young children if they would like to join them in a simple goodbye ritual, such as making a card or drawing saying goodbye to the baby, or planting a flower or tree honoring the baby,” Stuempfig said. “These rituals do not need to be elaborate, but it can help children express their own grief when they see adults grieving in an honest and open manner.”
The important thing is to be present and open to any reaction your child may have. Emphasize that you are always there for any questions in the future.
“Try to accept all of their thoughts, emotions and behaviors with open arms, even if they are not reflective of how you feel,” Richards said. “This models acceptance and helps reinforce the concept that you will continue to be their safe haven no matter how they respond. If they do not seem impacted by the news, that is OK too.”
Don’t feel like you have to tell them.
“If the child was unaware of the pregnancy, sharing the news of pregnancy loss is a matter of personal choice for parents,” Stuempfig said. “If the child is exposed to parents’ sadness and grief, it can be helpful for the parents to fill the child in so that they do not begin assigning other explanations such as blaming their own behavior for their parents’ moods. Typically trying to keep things covered up results in more anxiety and frustration for the whole family.”
You can tell your child the reason you’re not feeling well by sharing the news of the loss or you can simply name the emotion and talk about that aspect. Richards advised saying something like, “Sometimes Mommy feels sad, but I talk to Daddy about it and I feel better. You have seen Mommy sad a lot lately ― it is not your fault, and I am going to be OK.”
If you already told your child that you were pregnant, it’s important to address the fact that you’re not anymore so that they aren’t confused, but you can also do that without going into the loss.
“In my situation, my son was too young to comprehend my pregnancy and the loss of it, so with much consideration and upon seeking consultation about how best to relay the news, we decided it was best to say, ‘We thought Mommy was pregnant, but it turns out she isn’t,’” Zucker explained. “When my son was 10, however, we had a frank and nuanced conversation about my 16 week miscarriage and how it affected me, our family, my work life and the age gap between my two children.”
Take care of yourself.
“Remember to take the space you need to take care of yourself, if not for you, then for your family,” Chaudhary said. “Children notice when something is wrong with their parents or caregivers and they feed off that energy. Grieve. Reach out to friends and family. Vent. Yell into a pillow. Cry. Join a group. Focus on you and your healing. Give yourself permission to take care of yourself.”
There’s no right or wrong way to grieve, so do whatever you need to do to cope with the loss. Talking to others who have experienced pregnancy loss can be helpful, although everyone’s story and healing process will be different.
“The worst you can do for yourself is ignore or avoid your feelings,” Yip said. “If your thoughts and emotions become intolerable or too much for you to handle, seek help from a mental health professional.”
Ask your doctor for recommendations for organizations that support families through perinatal loss. Stuempfig suggested turning to Postpartum Support International, which can help you find support in your area or online.
“There are resources available for you too and wonderful therapists who are trained in loss and grief,” said Shaw Borish. “And most importantly, I want you to know that your loss matters ― the fact that you are grieving means it mattered, it meant something.”