As reported by the Ledger, May 30, 2004.

An Unspoken Loss

Women Often Suffer in Silence After a Miscarriage

By Rebecca Mahoney

Marsha Lazenby and her circle of friends had it all planned out: they'd all get pregnant around the same time, and then their babies could all grow up together.

The plan went off without a hitch. One by one, each of the women got pregnant, Lazenby included. Their due dates were all only two weeks apart.

Then, eight weeks into her pregnancy, Lazenby miscarried.

"That was hard, watching them all have their babies," said Lazenby, 33, who lives in Lakeland. "Their (pregnancies) all worked. Mine didn't."

Though Lazenby has other children -- 3-year-old Zachary and 10-month old twins, Madison and Alexander -- she still grieves for the baby she lost. Each February she remembers the day in 2002 her doctor failed to find a heartbeat and the day she passed the fetus, and in September she remembers the day her baby would have been due.

But she keeps her feelings to herself. Like many other women who suffer miscarriages, Lazenby said she believes few people appreciate how devastating it can be.

"People do not understand. They think, `You were pregnant, and now you're not, and you'll get pregnant again,' " she said. "Until you've lost one and you thought you were going to have a baby, you'll never understand."

Lazenby's story illustrates a painful point: Though miscarriages are extremely common, society rarely recognizes them as a serious loss.

An average of 1-in-4 women suffers a miscarriage, according to the American College of Obstetrics and Gynecology, although that number varies widely depending on a woman's age. The rate is closer to 10 percent for women younger than 30 but climbs to more than 30 percent for women 35 and older.

Miscarriages are defined as the loss of a pregnancy in the first 20 weeks. The loss of a pregnancy after 20 weeks is considered a stillbirth. Most miscarriages occur in the first 13 weeks of pregnancy, the first trimester.

Despite their common occurrence, however, miscarriages are frequently regarded as a taboo topic.

"People don't talk about it," said Mary Casey Jacob, a psychologist at the University of Connecticut Health Center who works in the area of reproductive health and infertility. "Women find once they do tell people that they're likely to get unhelpful responses . . . or that people don't see it as a loss. They end up feeling like there's something wrong with them because they're sad."

And in many cases, having their feelings ignored can be as painful for women as the actual miscarriage.

"The hardest thing was not being taken seriously by other people," said Lori Baranowski of Lakeland, who had two miscarriages, one after the other. "They expected me to be over it almost immediately. But to me, as soon as I was pregnant, this child had a place in my life for the rest of my life. I had already imagined my life differently."

Guilt and Fear

Little is known about why miscarriages occur. The most common causes are chromosomal abnormalities, typically caused by a faulty egg or sperm cell, according to the National Institute of Health. Hormonal problems, infection or health problems in the mother can also cause miscarriage, the NIH said.

That mystery often leads to self-blame and frustration and can even cause friction in a marriage, said Jacob.

"Women ordinarily blame themselves," she said. "But there are very few things you can do to cause a miscarriage. If a pregnancy is going to stick, it's going to stick."

One or more miscarriages can also taint future pregnancies, said Holly Parker, a childbirth educator with Healthy Start coalition of Hardee, Highlands and Polk counties.

If they've suffered a miscarriage, "women are in fear during the entire next pregnancy," she said. "They worry about every little thing. They fail to be able to enjoy the pregnancy. Every twinge that is normal they perceive as something wrong."

That was the case for Crystal Sowers, a 37-year-old Lakeland woman. She said she was so anxious and stressed throughout the pregnancy she had after her miscarriage that she didn't relax until her third trimester.

"I tried not to let myself get excited about the pregnancy. . . . When I went for my first appointment, I was really thinking they were going to tell me that I had lost the baby," she said. "I remember (the doctor) showing me my baby and saying everything looked fine. My husband and I were so happy we cried tears of joy and relief."

Sowers has two older children, Melanie, 10, and Jimmy, 9, and baby Audra is now 8 months old. But Sowers said she still thinks about the child that could have been.

"When people ask me how many children I have, I proudly say three on Earth and one in heaven," she said.

Help and Understanding

After Baranowski had two miscarriages, she sought out others who would understand how she felt. She talked to women she knew who had suffered a miscarriage, and found support groups online where people understood her pain.

Eventually, her suffering subsided.

"Don't just sweep it under the rug and pretend it's not happening," she said. "Don't be afraid to grieve."

Finding the right support is key to recovering from a miscarriage, counselors say.

"It's about who will help you cope, no matter what," said Jacob. "Those are the people to talk to."

Some hospital workers and counselors are working to raise awareness about the emotional effects of a miscarriage, hoping education will lead to more compassionate attitudes toward women who have them.

In Minnesota, for example, HealthEast Care System in St. Paul has started having volunteer doulas available in the emergency department to help women and couples cope with the emotional loss of a miscarriage. Doulas are women trained in childbirth who provide support for women before, during and just after childbirth.

"Emergency rooms are set up to be technical, but the emotional support is not always available," said Shelia Priebe, the infant loss coordinator for HealthEast. "We wanted that emotional piece given to our patients, too."

Meanwhile, others are looking to draw attention to the grief a miscarriage causes men.

"People will come up and say, `How's your wife? How's she doing?' Nobody, including his wife, is going to ask him how he's doing," said Armin Brott, author of "The Expectant Father: Facts, Tips and Advice for Dads-to-Be" (Abbeville Press, 2001, $11.95). "He may have had all sorts of hopes and dreams for the baby. But because of the complete lack of attention paid to him, he's not going to be able to grieve the loss of a fetus in a way that a woman might be able to."

For Lazenby, recovering from miscarriage was a matter of time, patience, faith and philosophy.

She'll never forget the sadness of losing a pregnancy, but she also knows she wouldn't have the life she has now if she hadn't miscarried.

"I wouldn't have had my twins if I had had that baby," she said. "I think it was like God giving me my little one back."