Tom’s wife, Alison, was 12 weeks pregnant with what would have been the couple’s first baby when she started lightly bleeding. The couple, who asked to use only their first names, had gone away for a car show together. They drove straight home, switched cars and rushed to the hospital.
When they arrived, doctors performed an ultrasound and immediately confirmed a miscarriage. Alison was right on the cusp of her second trimester. The two of them had seen their baby on ultrasounds and listened to the heartbeat. They had told family members, and they were just starting to tell all their friends. They wanted, very much, to have a baby.
“I felt this, just, extreme sadness,” said Tom, whose first instinct was to worry he’d somehow killed their baby driving their sports car over bumpy roads. “I cried a ton right away, right there alongside my wife. It seems almost strange to say it now, but I felt angry too. I was almost mad at God. Like, why is this happening to us?”
Miscarriage, or the loss of a pregnancy before 20 weeks, is both highly common (according to the most conservative of estimates, about 10 percent of known pregnancies end in a loss during the first trimester) and intractably taboo.
An outpouring of media coverage, celebrity anecdotes and wrenching personal stories on the topic has helped change that over the past decade or so, but not enough. A recent survey showed that Americans said miscarriage is far less common than it actually is and were widely misinformed about its causes, attributing pregnancy loss to stress or moving heavy objects. In fact, roughly half of early miscarriages are the result of pure chance, like the embryo receiving an abnormal number of chromosomes during fertilization.
This confusion contributes to the emotional toll it can take on women: 40 percent of the women in that survey who had a miscarriage said they felt very alone, and other studies showed that up to 20 percent of women who lose a pregnancy struggle with subsequent depression and anxiety.
Far less is known — and said — about miscarriage and men, and until that changes, men like Tom, who said he had no one to really speak with about his experience, all too often grapple with the emotional fallout of miscarriage largely on their own.
“This still tends to be considered strictly a woman’s topic by a lot of people, including mental health professionals,” David Diamond, a psychologist and an associate professor with the California School of Professional Psychology who often works with people struggling with pregnancy loss and infertility, told HuffPost.
“But men have lots of different kinds of reactions, and they are affected by these sorts of things — sometimes very deeply affected,” he said.
A typically different way of processing emotions
With virtually no research on how men process miscarriage, mental health experts have to rely on anecdotal experiences to understand the issue. And while it’s inaccurate to speak in generalizations about gender and mental health, experts said they recognize certain common patterns in how many men respond to miscarriage.
“Men often express many emotional reactions in different ways than women, so if a man is suffering from grief, he doesn’t necessarily cry or emote about it in a way that therapists or their wives might be looking for,” Diamond said. “They take action. They avoid. They become workaholics sometimes to cope or alcoholics. Men don’t always show their reactions as grief or loss, and sometimes the people around them — and they themselves — don’t connect that with the real source when it’s a miscarriage.”
In Tom’s case, his early tears in the ultrasound exam room almost immediately gave way to a sense that he needed to be his wife’s rock.
“I don’t want to say I felt like I couldn’t have my own emotions, because no one ever said that,” Tom said. “But I felt like I had to put them aside. She needed me to be strong for her.”
Dan Singley, a San Diego–based psychologist who focuses on men’s mental health and reproductive psychology and is the media chair for Postpartum Support International, said men in our culture are socialized to be stoic.
“One common reaction that I see with the dads who experience a miscarriage is a profound sense of guilt,” he said. “And the guilt is very often the result of the fact that he himself is struggling. He’s got a lot of anxiety and depression but doesn’t feel entitled to it — kind of like, `Hey, I’m not the one who lost the baby, so what right do I have to be taking up her emotional bandwidth with my issues?’ That dynamic gets to a much broader social phenomenon in which we train boys, adolescents and men.”
The challenge, then, is that men who are really struggling after a miscarriage often fail to get help. This is in part because they do not necessarily present their grief in a way that others recognize. Male depression often goes undiagnosed because men often show different signs and coping mechanisms from women and are generally less likely than women to seek help for mental health problems when they crop up.
And also because there is a perception that miscarriage, pregnancy, infertility — all of it — are primarily women’s issues, not men.
“It’s almost a call to action,” said Kate Kripke, a clinical social worker and the founder of the Postpartum Wellness Center in Boulder, Colorado. “We need more outreach to help men with loss and to get the right kind of support. It’s a problem, for sure.”
A difficult path for couples to walk down
Kripke said that in her private practice she has worked with many couples and has encountered a common split: For many women, the experience of miscarriage is emotional; they mourn the loss of something they already felt deeply connected to. For many men, it’s more logistical; they see a change in circumstances (my wife was pregnant, now she’s not) and a problem they try and work through by talking about next steps, like trying to get conceive again. Singley said there has not really been any research looking at this in a quantitative or even qualitative way — how common a reaction that is, to what extent it is primarily true in heterosexual couples or whether, say, a lesbian couple might experience a similar divide.
Around those different reactions, problems can arise.
“What can be tricky to help a couple understand is that that reaction doesn’t necessarily mean that the father didn’t want the baby as much as the mother wanted the baby,” echoed Kripke. “But the experience of actually being pregnant can be so different that expecting both partners to have the exact same experience around loss, particularly early on, is incredibly unrealistic.”
That is something that Jessica Psenski said she worked hard on in her relationship. She and her husband have a 3-year-old daughter and have been trying to conceive again for a year and a half. In that time, she has had three miscarriages, one that she described as particularly devastating because it came after she and her husband had an ultrasound and heard a healthy heartbeat.
“We had this experience of, after about a week or so of the initial shock and grief wearing off, he was still sad, of course, but he was almost trying to problem-solve,” she said. “Whereas I was in this place of deep, deep grief.”
The challenge, she said, has been to walk a fine line together, acknowledging that the miscarriages certainly affected both of them but specifically happened to her and in her body. Psenski said she was so stuck in her own emotions — as she put it, in her own devastation — that she isn’t sure she could have been there for her spouse to check in on him the way he needed.
But experts like Singley say what matters is that couples are able to talk about the issue and that society at large grows more comfortable with men talking about it too.
“We need to make space,” Singley said, “for a father to be upset about a reproductive loss.”