The loss of a pregnancy—whether it happens early on or is a late-term miscarriage—can have devastating mental and emotional effects. But a miscarriage doesn’t just have a powerful impact on the parents: the siblings of the baby can also struggle with this tragic loss.
Talking to children about this kind of loss can be difficult, especially if they are young. Helping them cope with their feelings and emotions surrounding it can be equally challenging, especially while the parents are managing their own grief.
In order to help your children have a better understanding of what happened, as well as how to deal with it, we spoke to mental health experts about this painful family situation.
Talking to Your Children About a Pregnancy Loss
When it comes to discussing a pregnancy loss with children, licensed clinical psychologist Dr. Nanika Coor says “it’s important to be truthful and direct.”
A young child’s comprehension of what happened may vary, she says, explaining that “children under three will probably not entirely understand the concepts of pregnancy or death, so the simplest explanation is the best. At around five years of age, children are beginning to have a better understanding of the cycle of life, and even more so after eight years of age.”
Dr. Coor says you can use language that is easy for any child to understand; for instance, you can say: “When a baby is growing inside, sometimes it grows all the way to being born like you and I did. Sometimes, while the baby is growing inside it doesn’t grow all the way to being born, and it dies when it is still very tiny. This is what happened to the baby that we were waiting for.”
Simple, clear, and age-appropriate language is best, echoes licensed psychologist Dr. Alli Kert, but she notes that as parents “we also need to take care not to share unnecessary information that could frighten or confuse them.”
“For example,” she says, “the medical details of the miscarriage are typically not necessary or helpful. Saying that ‘we lost the baby’ may lead the child to believe that the child was misplaced, and they too could be ‘lost.’”
The same goes for explaining death as “going to sleep,” says Dr. Coor, as this may confuse some children and make them fear going to sleep themselves.
While some families may go the scientific route, for those with religious faith, they can bring that into the explanation of the miscarriage, says family therapist Shanna Donhauser, LICSW. “If this is part of your value system, you can integrate your beliefs about what happened to the baby or where the baby went (i.e. heaven) to your children.”
Once you have broken the news to the child(ren), Dr. Coor suggests letting the children direct the line of questioning, and answer only what is asked. “Sometimes children may not ask any questions in an initial conversation, but questions could arise at some other time. It often happens that these are evolving conversations that take place over several days, weeks or months as children slowly process the answers you’ve given them.”
Another thing to consider when talking to your child, is to reassure them that this is not their fault, explains Dr. Kert. This is especially important if “they may not have wanted a baby sibling, and may fear their wishes could have somehow caused the loss.”
Comfort and reassurance can be key, she says, as “children benefit from the reassurance that they are OK, their parents will be OK, and they will continue to be taken care of.”
How to Deal with Your Child’s Reactions
“Every child reacts differently to loss, just as every adult does,” Dr. Kert notes. No matter how your child responds to the news, what’s important is to give them the space and time to process and ask the questions they need.
Routine is also healthy for any child, Dr. Kert says, adding, “Doing the best to maintain the normalcy of their daily lives will help to provide comfort and security.”
Some children may even benefit from doing things like drawing, writing, or memorializing the baby through making a memory box, she says. For older children, they can perhaps raise money for an organization that supports the health of mothers and babies.
Another major tool at your disposal as a parent is reading materials that speak to children., Dr. Coor suggests “using age-appropriate books, [which] can help children begin to understand the concept of death and the ambiguous loss of something you never got to know or see.” (Some recommended book titles on this subject include I Miss You: A First Look at Death, The Goodbye Book, and The Memory Box: A Book About Grief.)
For a child who is having a particularly difficult time coping with the death of their sibling, family therapy is a viable option. “A family therapist can help a family dealing with pregnancy loss process the ways that the loss has impacted the functioning of the family and what can be adjusted to improve family dynamics,” Dr. Coor explains.
Family therapy can also be beneficial “if the miscarriage was particularly traumatic and the child witnessed the trauma,” adds Donhauser. While a family therapist involves parents and possibly other siblings, a play therapist may be a good option for children aged 3 to 11 who seem distressed with the loss or the disruption it has brought to their lives.
“Play therapists make available to children a variety of toys, art supplies, and drama activities that allow them to express their experiences and struggles in the form of play,” says Dr. Coor. By engaging with children in play, therapists are able to help them work through difficult emotions and strengthen their resilience. Play therapists will also guide parents in supporting their child as the family copes with the loss.”
Managing Your Own Grief, Along With Your Child’s
While your instinct as a parent is to, of course, help your children, it is of the utmost importance that you get yourself the help you need during this time as well. “Short-term counseling can really help people process trauma,” says Donhauser.
She also recommends “reaching out to trusted friends and family members, finding a local support group, developing a regular mindfulness or self-compassion practice.” Parents should also make sure they are prioritizing sleep, and activities like gentle exercise or time outdoors can help a parent begin to heal.
Parents should also keep in mind that everyone manages the emotions following a miscarriage differently. As Dr. Coor explains, “Some people speak openly about their feelings and others prefer to be private about them.” You have to do what’s right for you and your family and never feel like there is any “right” or wrong” way to feel and there is no timetable for “getting over it.”
Simply put, in the wake of anything devastating, like a miscarriage, Dr. Coor says, “The best thing any parent can do in the service of their child’s well being is to attend to and protect their own mental wellness.”