Pregnancy Loss: Understanding Grief After a Miscarriage or Stillbirth

If you’ve had a miscarriage or a stillbirth, you may be carrying something that few people around you can see. You might be grieving a baby you’d already imagined, a future you’d begun to plan, or a pregnancy you’d barely told anyone about. Whatever you’re feeling, including numbness, anger, relief, or a grief that seems bigger than you expected, it’s a recognized, common response to a real loss. This guide explains the terms, what research says about how people are affected, and what can help. Many people use the word “baby”; others don’t. Use whatever words are true for you.

What do “miscarriage” and “stillbirth” mean?

In the United States, a miscarriage is usually defined as the loss of a pregnancy before 20 weeks. A stillbirth is the loss at or after 20 weeks, according to the CDC, and is sometimes divided into early (20 to 27 weeks), late (28 to 36 weeks), and term (37 weeks or later). Health care providers also use terms such as “early pregnancy loss.” The American College of Obstetricians and Gynecologists (ACOG) defines early pregnancy loss as a nonviable pregnancy in the first 12 weeks or so. The dividing line is a medical convention, not a measure of how much a loss matters. For what to expect after a stillbirth in particular, see our guide to what happens in the hospital and in the days after a stillbirth.

How common are they?

More common than most people realize, which is part of why they can feel so lonely. ACOG estimates that early pregnancy loss occurs in about 10 percent of clinically recognized pregnancies, and the NICHD notes that pregnancy loss can happen so early that a woman may not know she was pregnant. About 80 percent of pregnancy losses occur in the first trimester. Stillbirth affects about 1 in 175 pregnancies in the United States, according to the CDC and March of Dimes. The risk of early loss rises with age, according to ACOG’s guidance, but loss can happen to anyone.

Why did it happen, and was it my fault?

Often there’s no answer, which is hard in its own way. The NICHD says that in many cases providers can’t identify a cause of pregnancy loss before 20 weeks. ACOG says the reasons for most stillbirths are unknown, though some possible causes include birth defects or genetic disorders, problems with the placenta or umbilical cord, infections, and medical conditions in the pregnant person. The Virginia Department of Health notes that when no cause is found, people may blame themselves, live with guilt, and fear losing a future pregnancy. If you’re asking “what did I do wrong,” know that this is one of the most common reactions, and ask your provider directly what the evidence says in your situation. For an early loss, ACOG’s guidance is that testing to look for a cause usually isn’t recommended until after a second consecutive loss; after a stillbirth, ACOG says it’s normal to want to find a cause and describes the most useful tests as evaluating the placenta, an autopsy, and genetic testing.

What does grief after pregnancy loss look like?

It varies, and it doesn’t follow a schedule. Many people describe sadness, anger, guilt, anxiety, difficulty sleeping, trouble concentrating, and a sense of emptiness, as well as physical effects as the body recovers. Some feel little at first and are hit later; see our guide on why grief can hit months later.

Research shows how common significant distress is. In a large prospective study of early pregnancy loss led by researchers at Imperial College London, 737 women were followed after a miscarriage or ectopic pregnancy at three hospitals. One month after the loss, 29 percent met criteria for post-traumatic stress, 24 percent had moderate to severe anxiety, and 11 percent had moderate to severe depression. Nine months later, 18 percent still met criteria for post-traumatic stress, 17 percent had moderate to severe anxiety, and 6 percent had moderate to severe depression. In other words, intense reactions are not unusual, and for many people they ease over time while for some they last.

Does it matter how early the loss was?

Not in the way people sometimes assume. Early loss can bring deep grief, and later loss isn’t automatically harder. Grief isn’t proportional to the number of weeks, and a loss that others don’t think of as a “real” baby can still be a real loss to you. An expert quoted by Today’s Parent cautions that comments like “at least it happened early” suggest someone has the right to grieve only for a certain length of time. See our guide on what to say to someone after a miscarriage if you’re on the receiving end of those comments, or wondering how to respond to someone else’s loss.

What can help?

There’s no single right way, but people often find these helpful:

• Acknowledging the loss. Naming it, whether to yourself, to your partner, or in a small ritual, such as lighting a candle, writing a letter, or giving the baby a name
• Talking with people who understand. Postpartum Support International runs online peer support groups for pregnancy loss and for stillbirth, and Share Pregnancy & Infant Loss Support (nationalshare.org) offers a national community and online support for anyone who experiences the death of a baby
• Letting your partner or closest people in. Partners grieve too, often differently; see our guide on partners and pregnancy loss
• Following up with your care team. Physical recovery matters, and the follow-up visit is also a chance to ask questions and mention how you’re really doing
• Taking the time you need. There’s no deadline for grief; see our guide on finding grief support

Our guides on remembering a baby who was lost, taking time off after a pregnancy loss, and helping children understand a miscarriage or stillbirth cover more.

For practical decisions after a loss, see burial, cremation, and funeral options after a miscarriage or stillbirth and birth and death certificates after a stillbirth.

When should I reach out for more help?

Consider talking with a doctor or a counselor who has experience with pregnancy loss if distress is overwhelming, doesn’t ease, or keeps you from functioning, or if you have intrusive memories, panic, or deep hopelessness. Support lines are free and confidential:

• National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262), 24/7, free and confidential support before, during, and after pregnancy
• Postpartum Support International HelpLine: 1-800-944-4773 (call or text); it isn’t an emergency line
• 988 Suicide & Crisis Lifeline: call or text 988 any time in the United States if you’re thinking about harming yourself

See also our guide on complicated grief, which explains when grief may benefit from professional help.

Will I be able to have a healthy pregnancy later?

Many people do. March of Dimes says that most people who have a stillbirth and become pregnant again have a healthy pregnancy and a healthy baby, and MedlinePlus likewise notes that many women who have a stillbirth go on to have healthy babies. A provider can run tests to try to find what happened and to help prevent another loss. It’s also entirely okay to feel afraid, or to need time before trying.

This is general educational information, not medical or mental health advice. Every loss and every body is different - your doctor, midwife, or a mental health professional can address your situation. If you are in crisis, call or text 988.

For the medical and emotional sides of trying again, see pregnancy after loss.