Men and pregnancy loss

by Anne Neville

R.N., R.M., Dip. Past. Psych., Dip. Marriage & Family Therapy,Cert. Interpersonal Relationship Therapy,  Accredited Grief & Loss Counsellor National Association of Loss & Grief (Vic) Clinical Member CAPAV. PACFA Reg: 21127

This article last updated February 2018

“It is important that the male finds an outlet for his grief – talking about the experience helps make it seem more real and provides a release from the anguish, fear, anger and the disappointment that is often involved in pregnancy loss.”

Emotional reactions to loss
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Bonding to the unborn child
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Neglected grief
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Case examples – miscarriage, abortion, infant death or separation
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Help available
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Introduction

Fortunately there is a greater awareness now of the impact that a pregnancy loss has on parents.  The loss of a planned or anticipated baby is usually accompanied by feelings of sadness, disappointment, doubt, confusion and even anger.   It not only signals the end of a relationship between the developing baby and its parents but also lost are the dreams, hopes and wishes that are an integral part of the pregnancy.  When embarking on a pregnancy the parents are “totally unprepared for death.  It comes out of the blue” (Lothrop, 1997).

Open Doors Counselling provides a Pregnancy Loss Counselling Service for people affected by the emotional turmoil that follows a variety of pregnancy losses – miscarriage, abortion, IVF attempts, ectopic pregnancy and stillbirth. There is a great diversity in the nature and severity of the psychological and emotional reactions seen and felt in both women and men following the loss of a baby.  Society in the main tends to acknowledge and focus on the impact of pregnancy loss for women whilst the grief of men can be   overlooked or forgotten – they go “unrecognized as grievers” (Zinner, p341, 2000).

Inquiries about how his partner is managing the loss of the baby can leave the male with the sense that he has to be strong for her and is not expected to grieve. For many men there are some additional emotions that may arise – “uncontrollable rage and anger, terrible loneliness and isolation, as well as anguish and despair” (Carr-Gregg, 2002).  It can be said that men may be at a greater risk of not fully healing from the loss than their partners because of the way they try to manage their grief.  They may feel helpless in the face of their partner’s grief but it is important that male grief is acknowledged and validated.  To deny that men grieve would somehow be denying an important part of their humanity and sensitivity.

The Nature of Grief

Grief is the very natural response to the loss of someone or something that we love and value.  The mourning process enables us to explore the meaning of the loss, say our “goodbyes” yet maintain a connectedness and reach a new order in our lives.  There are no simple shortcuts to grieving.  If we don’t experience our grief consciously we may find ourselves becoming depressed and sick and/or our lives being undermined or affected in many ways.  Repressed grief may be triggered by some other significant event later in life that can be confusing and seem to make no sense.

Most parents who have lost a child may not anticipate how much time they may need for their grief journey.  They may experience their grieving as a journey with a number of very loosely defined stages that they will encounter.  Grief is not a tidy process but rather meanders all over the place – sometimes spiralling, sometimes seeming to stand still, inching forward and yet appearing to go backwards.  It is how it is – there is no “right” way to do grief.

Shock, numbness and a sense of disbelief are initially felt.  These give way to the raw reality and the chaos of fully experiencing the loss.  This stage of grief may take a considerable length of time.  Too often there are pressures that urge us to foreclose on a healthy period of grieving, leading to a more lingering and complicated bereavement.

Men and Emotions

By and large, men have been conditioned not to express their emotions. From an early age the male child has been encouraged to “cap” his more sensitive emotions and therefore his pain has tended to be denied or trivialized. One only has to witness the ridicule in the schoolyard that may greet tears from a punch, kick or rejection. A “competitive and aggressive nature is encouraged and accepted but sensitive behavior is suspect” (Scully, 1985, p.99).

If a man has learned to squash his feelings, he will not be comfortable with expressions of his more sensitive self.  He may have chosen to adopt a position of invulnerability and learned to act tough (Burnard, 2003) in order to protect himself.  All emotions except anger may be seen as a weakness.  Therefore, bottled grief may lead to emotional expression in more aggressive ways that are subsequently damaging to relationships.

When a man experiences emotional distress he may automatically reinforce these discounting messages, denying his pain and isolating himself.  This may indicate to others that he is coping well, is strong or in many instances may signal to his partner that he is unaffected by the loss or doesn’t care.  However, the truth may be quite the opposite.  A man may feel a great sense of sadness but doesn’t permit himself a period of mourning.   Instead a man’s grief is often demonstrated through irritability, anger management and addictions (Burke, 2007).

Men typically do not talk about their loss in the manner that women do and therefore don’t have access to opportunities to emotionally off-load.  Some men fear that their partner’s expressiveness means that they will “never get over” the loss. Gender differences in mourning may be reflected in the statement that “men sigh and women cry”.

In his book on male depression, I Don’t Want To Talk About It, Terence Real writes that “men have the capacity to deeply repress areas of loss and pain” (Real, 1998). They find it hard to reach out for help in spite of the pain they may suffer.  We know also that men tend to be more solution-oriented and seek to find something that will “fix” the problem. This can be a defence to avoid feeling their own pain. Men often grieve in a way that is quieter and less visible and, if not identified as bereaved, can find themselves “left outside the ranks of those who grief is responded to and validated” (Zinner, 2000).

For many men the impact of a miscarriage is less intense than that experienced by their partner. This may be particularly so when the loss occurs early in the pregnancy – when their degree of bonding may be less than their partner’s.  The loss may be expressed as a “sad event” rather than a death.  Others, however, do feel a deep sense of grief and it is unfair to judge a man’s grief by how much he “shares” it with others. A man’s pain “cannot be judged by outer appearances or the abundance of tears” (Golden, 1996).

While previous studies have linked pregnancy loss to mental health difficulties in women, few researchers have examined the impact on men.  However, researchers from the University of Queensland have found in a new study (Creagh, 2011) that young men whose partners have had an abortion or miscarriage are twice as likely to develop depression as those whose partners have never been pregnant.

It was found that those men whose partners had experienced pregnancy loss were:

  • 60% more likely to have an alcohol abuse problem than men who reported their partner had never experienced a pregnancy.
  • 80% more likely to have a cannabis abuse problem than men who reported their partner had never experienced a pregnancy.
  • 70% more likely to have an illicit drug (such as heroin or methamphetamines) abuse problem than men who reported their partner had never experienced a pregnancy.
  • Twice as likely to have depression than men who reported their partner had never experienced a pregnancy.

Those men whose partners had had miscarriages were three times as likely to suffer from anxiety than men whose partners had never experienced a pregnancy (Creagh, 2011)

A father may experience an uncertainty about what to do and say in the face of his partner’s pain – particularly in the case of early pregnancy loss. He may find it difficult to cope with her sharing on an emotional level and therefore may misinterpret her needs.  A conflict arises from his self-image as a provider and protector in his relationship with his partner. A sense of failure may lead him into isolation in his grief. He may feel he has to be the strong one who props up his partner.  The ensuing feelings of powerlessness, helplessness and a sense of guilt are common reasons why men withdraw.   Rather than acknowledging his pain he may avoid it, deny it or block it, moving into a more withdrawn state that may be interpreted as insensitive.  This may lead to “disenfranchised grief” – grief that is disallowed, pushed away and unresolved (Doka, 1989).

Men can also be deeply affected by an abortion and may feel even less able to express their sadness and anger or to seek help.  We have both men and women attend our Rachel’s Vineyard retreats for post abortion healing.  Amongst the men who have attended are those who have felt totally helpless to prevent their partner’s abortion as well as those who have insisted that their partner have an abortion.  Having men present on the retreats adds a special dimension for participants of both sexes.  Seeing sadness and remorse expressed by a male for his part in an abortion helps break through the anger and resentment for the woman who felt pressured by her partner. For the men, seeing women express their emotions can encourage them to do the same.  Recently a young male, ‘Ben’, said how good the retreat had been and thanked the women in the group for supporting him in his sadness. He said how good it had been for him to be with grieving women as that had “shown us men how to do that” – he was referring to allowing his emotions to surface and how to cry.

‘Michael’ – an abortion

‘Michael’ was 20 when his girlfriend became pregnant.  She wanted only her parents to know and when they took charge of the situation Michael wasn’t able to see her again.  She was whisked away to have an abortion very quickly and when she returned she looked, in Michael’s words, as if “the life was sucked out of her”.  Michael felt numb and helpless and the abortion put strain on their relationship and ultimately it folded.  Michael had no one to speak to – he hadn’t told his parents because he’d been told to not speak of it again – so he buried his emotions and began to mask his pain with alcohol for many years.  Fortunately, Michael has been able to work through his many emotions with an understanding counsellor and has made a memorial for his aborted child.

Allowing oneself to grieve may actually lead to a fuller understanding of oneself as well as discovering inner qualities that may have not been developed but for the loss.  A time of sorrow may help to develop new and healthier ways of relating to others.  It was French novelist Marcel Proust (1871 – 1922) who said: “Happiness is beneficial for the body, but it is grief that develops the powers of the mind.”

‘Paul’ – a miscarriage

‘Paul’, supporting his wife through a miscarriage, told me of his inadequacy in the situation – not knowing what to say or do to alleviate his wife’s distress. He tended to assume blame for the miscarriage saying, “I don’t ever want to put her through this again”.  He and his wife had been trying to become pregnant for a year. It was evident that for Paul there was the underlying fear that a subsequent pregnancy could also fail.

Paul experienced a sense of inadequacy, guilt and failure which are common male responses to grief (Lang & Gottlieb, 1993). When a man is faced with a situation that he is unable to control, he often sees himself as a failure (Doka & Martin, 1998). Other men have reported that anger has replaced their initial feelings of disbelief and numbness. “Why us?” is a common reaction and at times feelings of anger have been displaced onto partner or spouse. Relationships can be severely tested after a loss.

According to physicians, men have a tendency to blame their spouses or themselves for something they may have done, or conversely not done, during the pregnancy (Pizer, O’Brien, 1980). For instance, the man may take on the responsibility for the miscarriage if it was preceded by sexual intercourse. Also the male may feel his virility and masculinity may be in question in what he sees as his inability to produce a live child (Speck, 1978). These reactions are not only confined to loss in miscarriage but also abortion.

‘David’ and ‘Julie’ – a recent abortion

When ‘David’ and ‘Julie’ came in for counselling following an abortion, both stated that they didn’t blame the other. However, as counselling progressed they came to recognize that in fact that was exactly how each of them did feel.

Their abortion decision had been based on a crisis in their financial situation and the fact that David was temporarily unemployed. Not long after the abortion he began working again. He realized they would have managed but buried his guilt and anguish.  Julie felt the decision had been left up to her when David told her he would support her in whatever she decided to do about the pregnancy. This she interpreted as him placing all the responsibility on to her, and his lack of communication after the abortion she saw as disinterest and insensitivity. The more upset Julie became the more David withdrew into himself – her crying led to a heightened sense of guilt and inadequacy. He believed that he was to blame for her pain and instead of sharing his fears with her he pulled back and the relationship became strained.

David was initially able to express his bottled-up feelings with one of our counsellors and then with Julie. This led to a deepening of their relationship once communication was re-established and each was able to freely share their pain with the other. Julie acknowledged that she had wanted David to show her that he too was affected by the decision to have an abortion.

‘Diane’ and ‘Nick’ – an abortion 10 years ago

Commonly the grief associated with an abortion decision may be unresolved for many years. Following publicity for one of our regular ecumenical Remembrance Services for pregnancy loss, a woman who was married with 3 children contacted me.  ‘Diane’ and her husband ‘Nick’ had an unplanned pregnancy whilst both were at university. At the time they felt their only option was to have an abortion.  Now some 10 years later they both still grieved for their first child. Fortunately they had been able to grieve together and share their pain. Many relationships we have found to disintegrate because of a lack of communication and a growing estrangement.

This couple gained considerable comfort from our Remembrance Service for Pregnancy Loss and Nick confided that he felt more at peace. For years he had blamed himself for not finding a way to somehow enable them to go through with the pregnancy at the time.

‘Jason’ – death of a baby 7 days old

‘Jason’ found it difficult to deal with his grief after the loss of his daughter 7 days after her birth.  He had just been through the second anniversary of her birth and death and was struggling to hold it all together.  He had felt the pressure to ‘be strong’ for his wife and their other children and, it would seem, had not had much support for his own distress.  He said that he felt so very lonely and isolated and that he thought no one really understood how it was for him.  People usually asked him how his wife and children were managing – no one actually asked how he was.

Work and everyday life were becoming increasingly difficult and Jason recognized that he needed help.  Information was given to Jason for a referral to a grief counsellor in his home state and some other strategies for expressing his emotions were suggested.  Breaking Jason’s sense of isolation and validating his right to assistance were important in meeting his needs.

‘Tony’ – an abortion 16 years ago

At another one of our Remembrance Services I met ‘Tony’, 33, who drifted into the church after calling to see the minister on the off chance that he would be free. He decided to stay for the service and later told me how he had finally been able to acknowledge the child he had lost through abortion when he and his girlfriend at the time were both 17. During the ensuing 16 years he had at times been troubled by the memory.  That evening he found a great release in being able to think and talk about the child and speculate on what might have been.

‘Andrew’ – separated from his child

For ‘Andrew’, 22 and at university, the grief experience was a little different, but a significant loss none-the-less. When his girlfriend became pregnant, his first reaction was to insist on an abortion because of his need to finish his course and find employment before supporting a wife and family. ‘Jane’, however, insisted on going ahead with the pregnancy. The relationship broke down and they separated. Several months after his son was born Andrew saw him for the first time. He was instantly enchanted by the robust blonde-haired baby.  Sadly for Andrew, Jane went her own way, cutting off all contact.

Andrew came to Open Doors to work through his guilt associated with his initial insistence on the abortion and also the enormous pain of losing contact with his son. His loss was two-fold – his son and the relationship with his girlfriend whom he had originally planned to marry.

Andrew’s case tends to draw our attention to the difference there may be between the mother and the father in the investment in the unborn child. This may be so in the case of all types of pregnancy loss.  The bonding process may differ greatly. For the mother, it usually occurs early in pregnancy and is reinforced by the bodily changes (Lieter, 1986). For the father the pregnancy may be a little unreal until more tangible evidence is visible such as the woman’s changing shape, or when he is able to feel the baby’s movements.

Grief overlooked

What we are witnessing in our Pregnancy Loss Counselling Service is the impact that pregnancy loss has on many men. It is important to recognise that such a loss may evoke a strong emotional response in the male, eliciting sadness, anger, frustration, confusion and other unpleasant emotions. It is normal for a man to experience a grief reaction, however he may be overlooked or neglected in his loss and find it difficult to access support. He may find himself cocooned in loneliness, pain and sadness and also his withdrawal may be misinterpreted.

It is important that the male finds an outlet for his grief – talking about the experience helps make it seem more real and provides a release from the anguish, fear, anger and the disappointment that are often involved in pregnancy loss (Borg, Lasker, 1981). Ventilation is a necessary part of healing. Tears are healing also and maybe they are angry tears that need to be shed. There is nothing un-masculine about seeking help to grieve. It takes time and is a painful process but it can lead to resolution of inner conflicts, a greater self-awareness and more fulfilling relationships.

In the words of then Associate Professor Michael Carr-Gregg, himself a bereaved father:  “Open, honest, sensitive communication is the key to getting through to the bereaved man.  We need comfort and understanding to live through the stages of grieving and to be guided through unfamiliar emotional terrain” (1994).

Help available

The Pregnancy Loss Counselling Service at Open Doors is open to anyone experiencing a pregnancy loss.

Our Remembrance Services for Pregnancy Loss offer an opportunity for both men and women to reconcile the grief of any pregnancy loss in a very intimate, confidential and comfortable environment.

The Rachel’s Vineyard Retreat program is also available for anyone looking for spiritual and psychological healing after an abortion.

For further details about any of these services contact Open Doors on (03) 9870 7044 or freecall outside Melbourne 1800 647 995.

References

Borg, S., Lasker, T. Miscarriage. When a Pregnancy Fails. Families Coping with Miscarriage, Stillbirth and Infant Death. Beacon Press, Boston, 1981.
Burke, K. Redeeming A Father’s Heart. Men Share Powerful Stories of Abortion Loss and Recovery. AuthorHouse. 2007
Burnard, D. The Path to Men Behaving Well. RelateWell. Vol.7, No.3. September 2003.
Carr-Greg, M. The grief of a father losing a child shortly after birth.  SANDS (Vic) Newsletter.  Issue No. 61 February/March 1994.
Carr-Gregg, M. A father’s grief is just as profound. The Age, Melbourne. 14.1.2002
Creagh, S. Pregnancy Loss linked to Depression in Young Men. http://theconversation.edu.au/pregnancy. Accessed 6/10/2011
Doka, K. J. Disenfranchised Grief: Recognizing Hidden Sorrow. Lexington, MA: Lexington Books. 1989
Doka, K.J. Masculine responses to loss: Clinical implications.
Martin, T. L. Journal of Family Studies, 4. 143-158. 1998
Doka, K. Disenfranchised Grief.  New Directions, Challenges and Strategies for Practice Research Press. 2002
Golden, T. A Tree for my Father. M.E.N. Magazine, March 1996
Lothrop, H. Help, Comfort & Hope after Losing Your Baby in Pregnancy or the First Year. Fisher Books.  USA. 1997.
Lieter, E.F. Miscarriage. Parental Loss of a Child. Research Press Co., Illinois, 1986.
Pizer, H., O’Brien, C. Coping with a Miscarriage. Prime Books, Mass. U.S.A., 1980.
Proust, M. (1871 – 1922) Quote: “Happiness is beneficial for the body, but it is grief that develops the powers of the mind.” http://brainquote.com Accessed 11/10/2011
Real, T. I Don’t Want To Talk About It. Scribner, 1998
Scully, E. Jean. Men and Grieving. Psychotherapy and the Grieving Patient. Ed. E. Mark Stein, Harrington Park Press Inc., N.Y., 1985.
Speck, P. Loss and Grief in Medicine. Bailliere Tindall. N.Y., 1978.
Zinner, E. Being a man about it: The marginalization of men and grief: Illness, Crisis and Loss, 8, 181-188, 2000. Cited in Disenfranchised Grief. New Directions, Challenges and Strategies for Practice. Research Press. 2002

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