Parental grief over a lost Pregnancy.

• Position: Mortality

A PREGNANCY LOSS at any point during the nine months following conception can be devastating. Couples have had the dream of becoming parents or providing a sibling for their other children taken from them, at least temporarily. No matter what type of loss a couple endures, they share with other bereaved parents a bond of sorrow as they live through the tragedy and try to cope with their grief, according to Perry-Lynn Moffitt, co-author of A Silent Sorrow: Pregnancy Loss and a lay bereavement counselor with the Pregnancy Loss Support Program of the National Council of Jewish Women, New York Section.

More than 80% of pregnancy losses occur in the first trimester. As common as these events are, the impact they have often is misunderstood by the couple's family and friends, as well as the medical professionals who care for them, asserts Moffitt. Couples who have suffered an ectopic pregnancy, a blighted ovum, or an early miscarriage frequently are confronted by well-meaning comments that, in reality, turn out to be hurtful.

"If one more person [tells] me that I could always have another baby, I think I [will] scream," admits one mother. "Babies aren't replaceable" A father whose wife lost a fallopian tube during an ectopic pregnancy relates, "We don't know that we actually can have another baby--and anyway, we needed to grieve the one we wanted, but lost."

Granted, some of the issues that parents who experience a first-trimester loss face are different from those who suffer a full-term loss. A family who endures a stillbirth or newborn death has to decide whether to name their baby, or to say good-bye with formal rituals. Yet, a similar lack of tangible proof or public acknowledgement that a baby worthy of love and grief actually has died can leave those who have lost pregnancies in the first trimester bereft of any meaningful comfort. "Nobody knew what to say after my miscarriage, and because we didn't have a funeral, nobody bothered to call us to express their sympathy," one mother explains. "We felt so isolated and alone."

When parents do not receive support for expressing their sorrow, their grief can go underground and emerge later in more debilitating ways. "I sat on a lot of anger and sadness," laments a father whose wife experienced three consecutive miscarriages after their son was born. "I was so wrapped up in taking care of my wife and trying to comfort her that I never let my own feelings out. I snapped at people at work. I yelled...