Returning to Self-Love and Sex After Miscarriage
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Amy-Jo, 30, didn't notice her water break—she was only 17-weeks pregnant. A week later, she gave birth to her son, Chandler, who did not survive.
"It was my first pregnancy, so I didn't know [that my water had broken]," she tells Shape.
It was technically labeled a second-trimester miscarriage, though Amy-Jo says she doesn't appreciate that label. "I birthed him," she explains. That traumatic pre-term birth and the subsequent loss of her first child changed the way she felt about her body and her inherent self-worth, she explains. (Related: Here Is Exactly What Happened When I Had A Miscarriage)
"The second he was out of my body, my body deflated, and with that, I deflated," says Amy-Jo, who lives in Niceville, Florida. "I turned inward, but not in a healthy way, protecting myself. I was berating myself. How could I have not known? How could my body not have known and protected him? I still have to push [the idea] out of my head that my body killed him."
Grappling with Resentment and Blame
Amy-Jo is far from alone; wellness influencers, athletes, and celebrities like Beyoncé and Whitney Port have all shared their difficult miscarriage experiences publically as well, helping to highlight just how frequently they occur.
In fact, an estimated 10-20 percent of confirmed pregnancies end in a miscarriage, the majority of which occur in the first trimester, according to the Mayo Clinic. But the commonality of pregnancy loss doesn't make the experience any easier to endure. Studies have shown that women can experience significant depressive episodes six months after experiencing a miscarriage and that 1 in 10 women who've experienced pregnancy loss will meet the criteria for major depression. A reported 74 percent of health care providers think "routine psychological support should be provided following a miscarriage," but only 11 percent believe that care is being provided adequately or at all.
And while everyone will deal with miscarriage differently, many people report feeling a deep resentment toward their bodies. This is, in part, created by the insidious sense of self-blame many women feel after a miscarriage. When culture inundates women (even at a very young age) with the message that their bodies are "made" to have babies, something as common as a pregnancy loss can feel like a physical betrayal—a personal flaw that can lead to self-hate and internalized body-shaming.
Megan, 34, from Charlotte, North Carolina, says her first thoughts after experiencing a first-trimester miscarriage were that her body had "failed" her. She says she ruminated on questions such as, 'why did this not work out for me' and 'what is wrong with me that I couldn't carry this pregnancy?' she explains. "I feel like I still have those feelings, especially since I had so many people tell me, 'Oh, after a loss you're more fertile' or 'I had my next pregnancy five weeks after my loss.' So when months came and went [and I still couldn't get pregnant], I felt disappointed and betrayed all over again."
When It Carries Over Into Relationships
The resentment that women can feel toward their bodies after a miscarriage can severely and negatively impact their self-esteem, sense of self, and the ability to feel comfortable and intimate with a partner. When a woman who has suffered a miscarriage retreats into herself, that can negatively impact their relationship and ability to be open, vulnerable, and intimate with their partners.
"My husband just wanted to make everything right," says Amy-Jo. "He just wanted to hug and cuddle and I was like, 'No. Why would you touch me? Why would you touch this?'"
Like Amy-Jo, Megan says that this sense of body betrayal also impacted her ability to feel close to her partner. After she was given the green light by her doctor to start trying to get pregnant again, she says they felt more obligated than excited to have sex—and all the while, she couldn't clear her mind long enough to allow herself to be fully intimate with her husband.
"I was worried he was thinking, 'Well, if I was with someone different maybe they could carry my baby to term' or 'whatever she did, [she's the reason] our baby didn't keep living,'" she explains. "I was having all of these irrational thoughts that, in reality, he wasn't thinking or feeling. Meanwhile, I was still telling myself 'this is all my fault. If we get pregnant again it's just going to happen again,'" she explains.
And while non-pregnant partners often crave physical intimacy after a loss as a way to reconnect with their partners, the hit to a woman's sense of self and body image makes post-miscarriage sex off-putting, to say the least. This disconnect—when it's not combated with strategic communication and, in many cases, therapy—can create a rift in the relationship that makes it that much harder for couples to heal as individuals and as romantic partners.
A study published in Psychosomatic Medicine found that while 64 percent of women "experienced greater closeness in their couple relationship [immediately] after miscarriage," that number fell drastically over time, with only 23 percent saying they felt closer interpersonally and sexually a year after the loss. A 2010 study published in the journal Pediatrics found that couples who've had a miscarriage are 22 percent more likely to break up than those who've had successful pregnancies. This is in part because men and women tend to grieve pregnancy losses differently—multiple studies have indicated that men's grief isn't as intense, doesn't last as long, and isn't accompanied by the guilt that many women feel after a pregnancy loss.
That's not to say that everyone who experiences a miscarriage doesn't want sex or has to work through their grief to feel ready for physical intimacy with their partner. After all, there is no one way—let alone one "right" way—to react to a miscarriage or pregnancy loss. Amanda, 41, a mother of two living just outside of Baltimore, Maryland, says she was ready to have sex immediately after her multiple miscarriages, and her partner wanting the same helped her heal.
"I felt like I was ready to have sex again right away," she says. "And because my husband wanted to have sex with me too, it validated that I was still me as a person and I wasn't defined by that experience, as painful as it was."
But when you're having sex post-miscarriage, it's important to examine why. Amy-Jo says that after a period of mourning she "flipped a switch" and came onto her husband rather aggressively, ready to try to conceive again.
"I was just like, 'yes, let's make another one. Let's do this,'" she explains. "Sex wasn't fun anymore because I had a mindset of, 'I'm not going to fail this time.' Once my husband caught on, he was like, 'we need to talk about this. This isn't healthy for you to want to have sex with me just to fix something.'"
And that's where proper grieving, coping, and communication—both individually and with a partner—comes in. (Related: James Van Der Beek Shares Why We Need Another Term for "Miscarriage" In a Powerful Post)
Rebuilding Self-Love and a Loving Relationship
The loss of a pregnancy is considered a traumatic life event, and the grief surrounding that event can be complicated. One 2012 study found that some women grieve their miscarriage for years after it occurs and suggested that, because men and women grieve differently, including the non-pregnant partner in the grieving process is vital. Before a couple decides to hop back into bed, they should mourn together.
One way to do this is by using the reproductive story method, a technique commonly used by therapists and mental health professionals with patients in this situation. They're often encouraged to describe and work through their preexisting notions of family, reproduction, pregnancy, and childbirth—how they believed or envisioned it would all unfold. Then, they're encouraged to focus on how reality deviated from this original plan, in order to think beyond the ideals of reproduction, cope with their grief and any underlying trauma, and then realize that they're in charge of their own story and can rewrite it as they move forward. The idea is to reframe the plot: A loss doesn't mean the end of a story, but rather a change in the narrative that can result in a new beginning.
Otherwise, communication, time, and finding other activities that don't involve sex are vital in re-establishing one's sense of self, self-esteem, and connection after a loss. (Related: 5 Things Everyone Needs to Know About Sex and Relationships, According to a Therapist)
"Since my loss, I've been pouring myself into my family, my job, and exercising to remind myself that my body can do great things," says Megan. "My body wakes me up every morning, and I'm healthy and strong. I'm reminding myself of what I can do and what I have done with my life so far."
For Amy-Jo, spending time with her partner in non-sexual ways also helped her and her husband enjoy an intimacy that wasn't completely centered on trying to conceive or fixing what she perceived to be "broken."
"What ultimately got us there was doing things together that wasn't sex," she says. "Just being together and being relaxed around each other—it was like these little reprieves of just being ourselves and together and not being intimate that lead to the sexual intimacy in a normal, natural way. The pressure was off and I wasn't in my head about having to fix something, I was just in the moment and relaxed."
Taking It One Day at a Time
It's also important to remember that how you feel about your body can and probably will change from day to day. Amy-Jo has since given birth to her second child, a daughter, and the trauma around that experience—her daughter was born 15 weeks premature—introduced a whole new set of issues surrounding body acceptance and self-love that she's still addressing. (More here: How I Learned to Trust My Body Again After a Miscarriage)
Today, Amy-Jo says she's "in like" with her body, but she hasn't learned to fully love it again. "I'm getting there." And as that relationship with her body continues to evolve, so, too, does her relationship with her partner and their sex-life. Much like pregnancy itself, it often takes time and support to adjust to the new "normal" that follows an unexpected loss.
Jessica Zucker is a Los Angeles-based psychologist specializing in reproductive health, the creator of the #IHadaMiscarriage campaign, an author of I HAD A MISCARRIAGE: A Memoir, a Movement (Feminist Press + Penguin Random House Audio).
