"For years I have seen women come into the emergency room late a night having a miscarriage," she said. "My heart goes out to them. This is not something medicine does well, meaning we have a good way to assess and evaluate and work up patients, but what we don't care for the whole person."
"There is a norm in the culture to dismiss the loss very quickly," she said. "The most common response from family and friends is, 'Oh well, it's probably a blessing. There was probably something wrong with the pregnancy.' That might be true, but it's not an acknowledgement of the loss."
Grief can be as great with the loss of an early pregnancy as with the loss of a child, according to Gaudet.
"It's compounded exponentially if it's a second or more loss," she said. "It hooks into the fear, 'Is there something wrong with me? Will I be able to have a baby?' We don't support women in processing that."
Even women who didn't intend to become pregnant are "confused and distressed" by miscarriage.
"It's ... very primal and deep-seated," she said. "We are genetically programmed to procreate, and even if we choose not to, it's life-affirming for a woman to know she has the capacity to create life and give birth. When that is threatened, that's a loss, compounded by fear."
Despite research that suggests women should try to get pregnant quickly after a miscarriage, Gaudet advises waiting until that grief -- "whatever it looks likes" -- has been resolved.
"When they are feeling horrible and depressed and crying, it's not best to get pregnant," she said. "They need to honor and walk through the mourning process and they well know internally when they are ready to step into this again."