The Unspoken Loss
I remember the first time I visited my friend after she had just had a miscarriage. She opened the door for me and without saying anything went back to bed and covered herself from head to toe. She had this blank look and her eyes looked so empty. I wanted to reach out and hug her, but something stopped me. Maybe, it was still too soon for her, too fresh.
I sat quietly and said nothing, realising at the moment that I did not have to say anything, my presence alone was enough. “ Can you believe,” she said after a long while of silence, almost in a whisper, “The nurse handed me a pad and said, ‘It happens.’ Then she moved on to the next patient. There was no empathy whatsover…why does everyone assume that just because she was not born, she meant nothing? She was my baby! I left the clinic with my body bleeding and my heart quietly breaking.”
I held her hand and sobbed with her.
Every year, millions of women experience pregnancy loss with the majority going through it silently. In healthcare systems across Africa, miscarriage is treated as a routine biological event. But make no mistake – for the person experiencing it, the loss can feel anything but routine.
Miscarriage is common: according to the World Health Organization (WHO), about 10 to 15 percent of known pregnancies end in miscarriage, and that figure may be higher due to underreporting. But, as huge of a number as it is, emotional support is rarely part of the protocol. The focus is often on “managing the process.” And by that they mean all the physical actions like stopping the bleeding and ensuring there are no retained tissues, with little to no space for processing the emotional wreckage that often follows.
It is quite unfortunate how most reproductive health clinics do not even acknowledge grief. There are no pamphlets to educate, no referrals for counseling and certainly no language for the grief that comes with losing a pregnancy. And in SRHR advocacy spaces, the conversation still leans heavily on prevention and choice. Do not get me wrong, all these are crucial, but…..are they really enough? What are the emotional and psychological consequences of pregnancy loss?
I always wonder, why are people who miscarry often told by literally everyone (including loved ones and medical professionals) to move on quickly. I understand that it is difficult to grieve a baby the world never really met, meaning only you can understand your pain. I understand also, that these responses may come from a well-meaning place, but they often feel like erasure.
What Not to Say After a Miscarriage
- “At least you weren’t further along.”
- “You can try again soon.” (come on……)
- “Everything happens for a reason.” (please, what reason?)
- “Maybe it’s for the best.” (to whom?)
- “It wasn’t really a baby yet.” (how cruel)
- “Be strong.” (easier said than done)
- “Maybe it wasn’t meant to be.”
- “Just be grateful you can get pregnant.” (ehhh, naniiiii)
Look at it this way, these phrases shut down grief instead of holding space for it. They suggest that the pain is minor and the loss replaceable. It is almost like – this type of loss does not warrant such a type of mourning. In reality the people who miscarriage are not just grieving a loss of pregnancy but the loss of dreams, timelines and identity.
Instead, what grieving parents often need is acknowledgment.
Words like:
- “I’m so sorry you’re going through this.”
- “That must be really painful.”
- “I’m here if you want to talk – or not talk.”
- “Your loss matters.”
Grief in a Place That Only Talks About Options
Sexual and reproductive health and rights (SRHR) spaces have long fought for autonomy, access and informed choice. This is especially in regions where reproductive freedom is still contested. SRHR is huge on reclaiming agency in contexts where women and gender-diverse people have been denied control over their bodies for centuries.
Sadly though, miscarriage is frequently framed as a medical footnote in the SRHR discourse whose biggest emphasis is on contraception, abortion access, fertility and safe delivery – without a doubt all crucial areas. But when a pregnancy ends involuntarily, there’s little space in policy or community health to hold the grief that follows.
Emotional support is absent even within feminist or activist communities with people who’ve experienced miscarriage describing the feeling as though their pain didn’t “fit” the agenda. As one community health advocate told Sunset in Africa,
“Sp much is being said about reproductive justice, but miscarriage makes people uncomfortable. Funny how it doesn’t even have a slogan.”
The worst part about miscarriages, especially in places where womanhood is culturally defined by motherhood, is when women begin to blame themselves and feel like they have failed at something that should “come naturally” to every woman.
A Missed Link in SRHR: Post-Loss Care
A 2021 study published in BMJ Global Health found that while many low-income countries have robust frameworks for maternal health and safe abortion, post-pregnancy loss care – including emotional support – is severely underdeveloped.
If we truly believe in bodily autonomy, we must also believe in emotional autonomy which includes the right to grieve in peace, to be supported without shame and to heal with dignity. SRHR work must evolve to include miscarriage care not just as a biological event, but as a life-altering experience.
Cultural Silences, Gendered Expectations
In many African cultures, pregnancy is held in sacred regard. Most African communities view pregnancy as a celebration of continuity and legacy. It is also viewed as a divine blessing. So when that pregnancy ends in loss, the happiness that surrounds motherhood vanishes only to be replaced by a hushed silence that gives zero room for mourning.
Across different communities, a woman who miscarries may be forced not to talk about it because of the assumption that she might invite more bad luck or spiritual condemnation. (sometimes it is just the gossip those surrounding her are afraid of, tbh.) In some settings, it is treated as a sign of spiritual imbalance, a generational curse or the result of moral failure.
Even in urban and educated spaces, the pressure to “get back to normal” persists. Some faith traditions may offer prayers but avoid naming the loss. Others may skip acknowledgment entirely – after all, the child “wasn’t born,” so how can you mourn something “that never was”? (sigh)
But these women mourn the life they imagined and names they’d already picked. All the clothes they had bought with so much thought and joy – like in the case of my friend.
The Burden of Being Strong
I have always said that being told you are a resilient or self-sacrificing woman is not the complement most think it is. Because then the expectation is that you will bounce back, carry on and “be strong for the family.” At what cost does that strength come at? The cost of silence. It becomes a mask that hides anxiety, depression, sleep disturbances and even suicidal ideation. You are after all, a strong woman, right?
It becomes even worse for men grieving miscarriage because they are often left out of the conversation entirely. The emotional support gap for partners is almost non-existent. It is assumed that since women carry the physical weight of the loss, they should also carry the full emotional burden.
The Problem with Cultural “Moving On”
- In some communities, women are advised to get pregnant again as quickly as possible. What are you waiting for? They repeatedly get asked. It is masked as concern but really, it is just a form of erasure disguised as healing.
- Others will be quick to consult traditional healers but not therapists. Meaning, this is perceived as a spiritual issue and not a psychological one.
- Ceremonies exist for birth, marriage and death. I have never seen or heard of one for miscarriage.
Miscarriage exists in a grey space because there was neither a birth, nor a death in the traditional sense. But for the person who carried that life no matter how briefly, the grief is very real.
Making Space for Grief in SRHR Work
If SRHR is truly about choice, then it must also be about care. Care beyond a prescription or a discharge note. Just like every other type of loss, people grieving miscarriage deserve support that recognizes their loss and provides tools for healing. How? You may ask.
1. Integrating Mental Health into SRHR Services
Many healthcare providers in sexual and reproductive spaces are trained to deal with medical emergencies but not emotional aftermaths. Any stage of Miscarriage can trigger grief and trauma. Yet, mental health services remain inaccessible.
What we need:
- Mandatory mental health screenings post-loss, not just physical check-ups.
- On-site grief counselors or trained community health workers.
- Referrals to affordable or free support services, especially in rural and low-income areas.
2. Educating Health Workers, Advocates and Media
“My body, my choice,” “No woman should die giving life”
So many slogans, but where is the messaging for those who wanted the pregnancy but lost it?
Healthcare workers and SRHR advocates must be sensitized to talk about miscarriage as a part of the reproductive spectrum.
Training can include:
- Language to use (and avoid) when speaking with grieving patients.
- Cultural humility and awareness of how different communities process loss.
- Media guidelines for responsible coverage that avoids sensationalism and shame.
4. Community and Policy-Level Change
Miscarriage needs to be included in:
- SRHR policy frameworks as an issue that intersects with emotional wellbeing.
- Public health campaigns that address both maternal care and mental health.
- Community dialogue spaces like women’s groups, media forums and youth networks that normalize talking about miscarriage without shame.
Grief is a natural response to love and loss. And until SRHR work makes room for that grief it will continue to miss a vital part of what it means to hold reproductive rights with dignity.
We cannot continue to build SRHR movements that are bold about access but quiet about loss. A full spectrum of reproductive justice must include the pain of endings and not just the hope of beginnings.
To those who’ve miscarried and felt unseen, find comfort in knowing that your grief is valid.
