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OCTOBER 07
TALKING ABOUT MISCARRIAGE
EXPERT ADVICE ON HOW TO DISCUSS MISCARRIAGE WITH YOUR CHILDREN

There is often a great deal of pain, sadness and confusion surrounding a miscarriage—and that's just
what's swirling around in your own head and heart. But what about your children? How are they going
to take the unfortunate news?

Here, Michael D. Kaplan, MD, a child psychiatrist in private practice and Assistant Clinical Professor at the
Yale Child Study Center in New Haven, CT,  tells us when to have the pregnancy talk, how to handle the
miscarriage talk, what to expect from your children in response to the news and more.

THE FAMILY GROOVE:
When is it appropriate to tell your child that you are pregnant?
Dr. Michael Kaplan: This is a very personal question and there is no right or wrong answer. The best time to tell your child is when you are ready as a parent—but this does not mean that you can wait up until the time your water breaks. Children have a funny way of getting us to talk about topics long before we are ready. They seem to become magnets for those topics that make us most anxious. So, if a parent is feeling anxious about how to tell their child about the pregnancy, that child is likely getting a strong sense that something is up. As with most serious topics that arise in a family, telling our children about having a baby says more about us as parents and how we deal with tough issues, rather than the impact it will have any individual child.

Talking About MiscarriageThe best rule of thumb is to wait until you are out of the first trimester. The risk/benefit flips at that point, making miscarriage a far less likely outcome. Many parents are too excited to wait, and let their child know as soon as the home pregnancy test glows with the news of a pregnancy. It is important to remember that very young children don't know much about procreation, but are filled with lots of imaginative thinking. In the abstract, it doesn’t mean too much. And, in addition, if the outcome is poor, a toddler or young child, trying to make sense of a tragedy, will often feel some degree of responsibility.

Also, it is important for the parents, as a couple, to adjust to this kind of news before involving their young child. Modern parenthood offers few opportunities to maintain privacy; this is a good one to enjoy alone for a while. Remember, you will have many months to share this with your children.

An optimal time for telling your child is when they bring it up. Children will bring it up as an observation (they are always watching us). They need something concrete. A growing belly is a great jumping off point. So, if your child comments on how tired Mommy is or, more typically, how big Mom’s tummy is growing, strike while the iron is hot.

As with most things with young children, it helps to provide just a few basic bits of information. While the parent is all focused on all the implications, children like to consume news in brief chunks, like the online version of CNN.  Most kids want to know the facts, and just the facts. So while we fret about the development of sibling rivalry, the curious toddler just wants to figure out what is happening in her world.

TFG: What if your child asks about your pregnancy before you are ready to tell?
MK: It's best not to lie about something that will be hard to hide in a matter of weeks—and this is not a good subject to try and distract. The child, who asks before you are ready, is probably sensing your ambivalent state; that is enough to make any child uncomfortable. Asking the question, then, becomes a way to reduce the child’s anxiety. Anxiety is like a game of hot potato: you pass it to your child and then they pass it right back to you.

It is important to remember that you can't "harm" children with this kind of news.

TFG: How do you tell a toddler that you've had a miscarriage?

MK: It is always hard to talk about death with children. No matter the age, it is important to be frank, but brief. This allows the child to mull the facts over in her mind and then ask away. A mistake can be made in anticipating each and every potential question and then answering them like a champion debater. The risk is that you can overload your child with unnecessary information.

You can save yourself the trouble of having to talk about miscarriages if you wait until the end of the first trimester. For the toddler, keep it in the language that they know best: the language of growing things. Saying something like, "Babies start out by growing in mommy’s tummy. Most babies keep growing and then come out as they get born.  Sometimes the baby doesn’t grow as it should and doesn’t make it all the way to being born…”

TFG: How do you tell a preschool child that you've had a miscarriage?
MK: Telling preschool children is not that different from telling a toddler. The difference is in the conversation that ensues. The toddler most likely goes back to dumping sand out of a front loader, while the preschooler will pepper you with some questions.

Question-asking depends upon the individual makeup of your child. Some kids want to know everything—I call these kids “reporters.” Other children, interestingly, show no interest, and should not be forced into hearing the details of a miscarriage.

TFG: How do you tell a grade-school child that you've had a miscarriage?

MK: By the time children reach grade-school age, they can process information as it relates to others, but, more importantly, they can connect cause and effect in deeper ways. They also connect feelings with experience. A miscarriage causes great sadness in adults and can lead to marital discord. No matter the age of the child, it is helpful to the child if the parents express their feelings. Crying is okay. To hear sad news, but to see a forced smile on their mother’s face, leads to great confusion.

A grade-school child is beginning to gain the major concepts of death—that it is universal, irreversible, and that all life functions cease. 

TFG: What are some signs to look out for with regard to your child's behavior in response to your miscarriage?
MK: The child’s behavior is related to how they feel about the miscarriage, but with younger children they are going to be exquisitely sensitive to your availability. Any sadness in a parent inevitably creates a perceived, real, distance. Making sure that experienced, caring adults are available to your child during these rough times will help reduce the impact on them.

In response to a miscarriage, children might become more clingy or more distant. An upsurge in acting out behavior can be expected. And, usually, it is not the emergence of new behavior, but echoes of older patterns of acting out that emerge at this time.

TFG: How do you engage your child(ren) in the cycles of life without burdening them with such a heavy topic and/or your sadness about the situation?
MK: In a culture that values greater levels of openness with children, we often err on the side of providing too much information. While kids might appear to seek this out, they don’t necessarily need to be burdened with adult-level conversation. Be patient, they will grow up and you can talk with them like adults when they mature.

It is important to talk about life and death issues as they appear in your life—nature provides this for us all the time. In the spring, we see baby birds and all kinds of animals. Using nature displaces the intense emotions we have about the people around us onto more seemingly neutral objects. Children usually experience the loss of an animal (the classic is the dead hamster in nursery school) before they lose a close person. It is sad, but much safer, to bury a small pet rodent, than a loved one. Talking about the circle of life as it applies to nature, provides the building blocks of comfort that can be used when more tragic losses occur.

Got more questions for Dr. Kaplan, email them to info@thefamilygroove.com.

Click here for more advice and information on this topic in our article, “Understanding Miscarriage.”

EM—POWER TOOL

The Size of My Family Pick up a copy of The Size of My Family is Just Right For Me, an interactive book written through the eyes of a child about coping with the news that her mother has miscarried.
($18, www.amazon.com)
 


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