Miscarriage and Infertility: Ambiguous Losses

What followed for Aisha was a self-described “week of hell”—the emergency room trip, a stomach pump, the nurse who rebuked her, saying, “You tried to kill yourself. You don’t deserve sympathy.” This humiliation preceded commitment in a private mental hospital, a court hearing to determine her sanity, and the requirement that, before leaving the hospital, Aisha schedule an appointment with a counselor.

Aisha and her husband of three years were facing not only the reality of never giving birth to their own children but also the possibility of a diagnosis of cancer. It was too much to bear, and after a day spent drinking with her husband and friends to calm down, Aisha went home and “tore the kitchen apart,” broke her arm against the wall, swallowed a bottle of antianxiety medication the doctor had given her, and then called her mother, who finally assisted Aisha in getting help. She sat down to wait for the emotional help she so desperately needed. No one was listening to Aisha. No one had grasped the totality of her pain. “I just want someone who can understand what I am going through,” she cried. From the moment she learned she could never bear a child, Aisha was grieving the loss of future plans that would never be realized. She would never be a mother, never hold her infant, and never have a family. All of those holidays, birthdays, years stretching out ahead of her, alone and barren.

She feared that her husband would leave her for someone younger who could give him children, and that she could never look at children again without being reminded of her loss. All she had ever wanted was to be married and raise a family. Now that dream was shattered.

How to go on? Why go on? The existential questions stretched like open fields for miles in front of her—questions that were not easily answered by the meaningless mantra of well-meaning friends and relatives: “You can adopt,” or “Relax, you’ll get pregnant.”

More than losing her footing, Aisha had her future plans yanked right out from under her in one horrible afternoon. She needed time just to accept the reality of her loss before she could even start to think about the future. It was months before she was able to accept the diagnosis. It was even longer before Aisha could start to dream again about the color, the texture, and the design she would weave into the rug of her new life.

Discussion Questions

1. What are some losses experienced by the couple and by the individuals in the couple?

2. What makes Aisha’s loss ambiguous?

3. What are the primary and secondary considerations a professional counselor would need to address?

4. How can you better help Aisha to grieve and move on to a healthier, more vital life?

5. With a peer as a client in this situation, role-play implementation of the task model of crisis assessment and intervention presented in Table 1.1.

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