The experience and grief of miscarriage suffers particularly from ignorance and misunderstanding.

Many grieving parents continue to be shocked and deeply hurt at the blithe sympathy, and even contempt, of others to their loss. Unless we have suffered a miscarriage ourselves, or walked closely with those who have, many of us have no idea of the horror and myriad pastoral implications that arise from losing an unborn child.

Zuckerberg’s challenge

Part of the problem is the silence that surrounds miscarriage, no doubt inherited from a past era, when wives concealed such from even their husbands. However, this is pastorally devastating and does little to comfort and support the grieving mother who is struggling with her own sense of failure. It was telling when Facebook founder Mark Zuckerberg announced, last August, that he and his wife had suffered three consecutive miscarriages: candid conversations broke out online, challenging the taboo.

Dear church members…

This silence needs to be broken in order for couples to journey through their loss in a healthy and godly way. The church family should by definition give a helpful response of biblical ‘meat’. Instead, we Christians are notorious for blurting out trite one-liners while we squirm in discomfort. Following our miscarriages, most of our friends and family either ignored the issue or said the most unhelpful things: ‘you do have two children’; ‘it just wasn’t meant to be’; ‘maybe it’s God’s way of telling you not to have any more’. Only a precious few were pastorally spot on!

This article seeks in some small way to enable church workers and members to pastor effectively and appropriately those going through this unique loss. Why is it unique? As we shall see, the physical implications of miscarrying a baby, combined with the emotional loss, means that miscarriage is, to say the least, pastorally complicated.

Health workers are not pastors!

It is important to note that health care professionals are not in a position to offer any meaningful support. Some can actually make the situation worse. The detached and patronising manner of my own obstetrician left me in great confusion and anger. He offered no careful words of sympathy and responded impatiently to my desire for a natural delivery of my loss. This meant that an already painful appointment turned nasty as he sneered at me, declaring that the surgical procedure was not an abortion. I couldn’t believe my ears! In my grief I was all too aware that my baby was already dead. Another couple, expressing their grief to their doctor, were interrupted: ‘Wait now. You can’t think of this as losing a baby – it was a foetus, a mass of cells. What you lost was just tissue, not a person.’

These are, perhaps, unusual examples where Christian medical ethics clash with the mainstream, but even the most gifted and compassionate health care practitioner cannot take the place of a pastor. Bereaved Christian parents need to make biblical sense of their bewildering loss, and this eternal comfort can only be found in the church.

Physical implications

The physicality of miscarriage is not for the faint-hearted – the bleeding alone can be extremely traumatic, stopping and starting over a period of weeks, adding to the emotional rollercoaster. It might be anything from a heavier period to a bath full of blood, clots and human tissue. In some cases of stillbirth (loss after 20 weeks of pregnancy), some women are forced to work through a painful and hopeless labour to give birth to the little one they have already lost.

Alternatively, many Christian couples are not given the time to request a natural delivery of their baby. Instead the mother is rushed in for surgery. This can be problematic, as many will struggle with their own ethical stance since this ‘dilation and curettage’ procedure is also used to perform abortions. Adding to this, there is no body to hold and grieve over: the foetus is taken away and destroyed. One bereaved friend explained she felt robbed of her baby and the ability to bury and mourn: ‘I don’t even know where they took my baby… probably to the hospital incinerator and I don’t even like cremation!’

Other possible physical implications include the suffocating darkness of postnatal depression… but with no baby. In the case of serious infection due to the loss, a hysterectomy might be necessary, resulting in infertility. If an ectopic pregnancy occurs, where the embryo develops in the fallopian tube, the removal of the baby and the tube is necessary. In this case the baby may still be alive and so the couple have to deal with the guilt of ending the pregnancy, even though the mother’s life was at stake. For many, a very early miscarriage can take weeks to be confirmed, if scans are inconclusive. It is a time when the parents live on a knife edge between hope and despair.

No womb of death

In pastoring a couple through miscarriage, one needs to appreciate the woman’s bodily experience of death. It is a very personal and unique type of bereavement because the dead body is actually inside her. These women need to be pastored sensitively and given biblical counsel and a reminder of God’s goodness and sovereignty over the womb (Psalm 139), even when a successful pregnancy is never reached.

Pastoral issues

Thus the pastoral issues that result from miscarriage abound. There are feelings of guilt and blame, as some women are mentally bombarded with the thought that they killed their baby and try to account for it physically. Then there is the strong sense of failure. This can be overwhelming, especially in the felt humiliation of multiple miscarriages, and can be detrimental to the woman’s self-esteem. Of course, we have not even considered the theological questions plaguing the couple: ‘Is God punishing us?’; ‘Is our baby in heaven?’. Another significant implication is the strain on the marriage, particularly as each partner might grieve in different ways. Pastoral care needs to focus on the husband as well as the wife; on the couple as individuals, as well as a unit.

Encourage grief

The most valuable thing we can do in pas-toring a miscarriage is to encourage grief. Implicit in the miscarriage taboo is the fact that for too long only ‘minimal grieving’ has been considered ‘acceptable’ (Maureen Rank, Free to Grieve). The world talks about losing a ‘pregnancy’, not losing a child. We seem to be uncomfortable labelling it a bereavement. Yet when my husband and I stood in front of our baby’s grave, trying to muster all our faith in a good God, there was little ambiguity: we had buried our sweet baby in the cold hard ground and the pain was merciless.

Grief is the healthiest response for the couple, particularly when it is not easily facilitated. ‘When a child dies in miscarriage, society provides no outlets for the grief. People don’t usually sympathise unless the mother has to be hospitalised. There is no body to mourn; no headstone is laid. Grief is dammed up in a reservoir with no floodgates to open’ (Rank). In the early days it is simply our duty as siblings in Christ to sit in silence and ‘mourn with those who mourn’ (Romans 12.15).

The gospel treatment

As we said, Christian parents journeying through a miscarriage will be desperate to make biblical sense of their loss. It was the coherence of the gospel that gave comfort in the seemingly senseless nature of our losses. In all the physical and emotional mess, the Easter victory of Jesus became our anthem and our kick against Satan’s defeated warmongering. Effectively pastoring a miscarriage means pointing the couple to the baby ‘conceived within a frail, sin-infected womb’ yet by the power of the Holy Spirit, as Jessalyn Hutto wrote in The Baby Given to Women Who Miscarry (Gospel Coalition). Babies die because of our union with Adam, but our union with Christ gives us a real, tangible hope.

Natalie Brand is a visiting Lecturer for Union School of Theology and author of Crazy But True: Connected to Jesus for Life (Bryntirion). An earlier version of this article was published in Affinity’s Social Issues Bulletin November 2015)