December is a hard month for Cory Beyer and Lisa Goodwin. Both women remember it as the time they began to celebrate their first pregnancies, and the first time they had to suffer the isolating grief of a miscarriage.
"It was going to be a big Christmas surprise to our families, but then we found out that it didn't have a heartbeat," said Beyer, of Tulsa, Okla. "It was a total surprise and shock."
To add to her pain, Beyer quickly learned that her sister-in-law was expecting. "As much as we wanted to celebrate her, we felt like we couldn't, and the family didn't understand why," said Beyer, a member of the Tulsa chapter of Mend, Mommies Enduring Neonatal Death.
According to the National Institutes of Health, up to half of all fertilized eggs die before the woman knows she is pregnant. Once a woman knows she is pregnant the miscarriage rate drops to about 15 to 20 percent. Most miscarriages occur during the first seven weeks of pregnancy. Miscarriages are defined as a pregnancy loss before the 20th week.
Although common, research shows that miscarriages fall into a unique category of loss: rarely mentioned, poorly understood and mourned differently by everyone involved. Some women rebound easier than others, but many are pushed into an isolating sense of loss and guilt.
"I heard comments by an older aunt, 'this is just god's way of taking care of someone who's unhealthy.' People don't know how to react," said Renee Henvey, who had a stillborn at 9 months in 2001 and a miscarriage in 2003.
"There is a stigma on miscarriages...not feeling that it is really a baby yet," said Henvey, who now has two boys and lives in the Dallas area. "It is a deep deep loss. My husband and I were definitely affected."
Doctors say women may also feel responsible for a miscarriage as if they didn't take care of themselves, although genetics problems and infections cause most miscarriages.
"Women have this idea that if they eat right, take their vitamins and go to the doctor everything is fine ... but there is this uncontrollable part of the biology," said Dr. F. Sessions Cole, chief medical officer and director of Newborn Medicine at St. Louis Children's Hospital.
Kristen Swanson, dean of Nursing at the University of North Carolina, Chapel Hill has studied couples' reactions to miscarriage and how best to counsel them after a miscarriage. Her latest research was published this October in Journal of Women's Health and Gender-Based Medicine.
Previously, Swanson has found that the pain of a miscarriage is just as intense as the pain of a stillborn, but the emotional pain of a stillborn lasts much longer.
Lisa Goodwin, of Houston, remembers December as the first time she had to go in for a dilation and curettage, a D&C, to remove the remains of her first miscarriage. Her third pregnancy also ended in miscarriage.
"I told all of the downtown medical center," said Goodwin, who was excited that she got pregnant relatively quickly after battling endometriosis -- a condition that often leaves women infertile.
"I had to tell people [about the miscarriage] for a solid year," she said. "If it came up at work I would have to just go and bawl and I'd have to wear waterproof mascara."