The work of bereavement specialist Kenneth Doka (1988) on “disenfranchised grief” provides a helpful prism through which to view pregnancy loss. Grief can become disenfranchised when a loss is not openly acknowledged, socially accepted or publicly mourned. In these situations, the relationship is not recognized, the loss is not recognized or the griever is not recognized. Artist Kathy Fleming of Minnesota, still affected by miscarriage decades later, says: “I remember life going on around me, whizzing by, but never engaging me. I felt held apart, invisible to people around me. I felt as if I were on the edge between being and nothingness, existing on the boundary line.”
In normal grief resolution, feelings subside gradually However, when grief is not acknowledged or accepted, grief resolution cannot occur and the griever is left stranded in a kind of emotional limbo. Formal studies and anecdotal evidence reveal that pregnancy loss can remain a longstanding grief if it is not addressed. We can begin to shift miscarriage and other reproductive losses out of the disenfranchised realm by validating that these are real losses and then developing meaningful responses.
But what does typical or normal grief look like? What does it mean to “accept” loss, let alone to “move on?” How do we move from numbness or drowning in sorrow to some kind of peace and acceptance? For years I have held on to a quote whose author I have long since forgotten: “Bereavement is not a state which one enters and departs; nor is it an illness from which one can be cured. It is a gradual evolving process that irrevocably changes the mourner.” These words remind me that there are no quick magic bullets for grief – not therapy, not art, not religion, although these are some of the best tools we have but there is a process that can be navigated.