Am I grieving?
You have lost your pregnancy in a sudden and distressing way so it is natural to feel grief. There can also be feelings of grief where a Fallopian tube has been removed and perhaps a sense of loss with the possible impact on fertility. You may have been through a traumatic experience and it is natural to feel grief. Grief is a very normal emotion after loss particularly in the early days and weeks and, although difficult to experience, is part of the healing process. Some might find grief can surface later or be triggered by another event. With grief, it is common to have many other feelings such as sorrow, anger, loneliness, sadness, shame, anxiety, and guilt.
Dr. Elisabeth Kubler-Ross suggests that there are five stages of grief following loss. It is important to remember that this is one set of ideas, that grief is an individual process, and is not a linear process.
1. Denial – At first, we tend to deny the loss has taken place and withdraw from the reality of what is happening. We may think that the diagnosis is mistaken and cling to a false preferable alternative.
2. Anger – We may then be furious at the person who inflicted the hurt (even if they are dead), at the world for letting it happen, or with ourselves for letting the event take place, even if, realistically, nothing could have stopped it.
3. Bargaining – Next the grieving person may make bargains e.g., asking, “If I do this, will you take away the loss?”
4. Depression – The person feels despair.
5. Acceptance – The person accepts the reality of the loss and new future. This is typically a calm phase with stable condition of emotions.
These stages are not a step-by-step process for grief, but instead are a combination of different thoughts and emotions at various times and intensities. Also, some people may experience only a few of the stages while others may not experience any of them.
Another grief model is Margaret Stroebe and Hank Schut’s dual-process model which identifies two processes: loss-oriented activities and restoration-oriented activities. Loss-oriented activities are those that relate to the loss and include experiencing sadness, denial or anger and dwelling on what has happened. Restoration-oriented activities include adapting to what has happened. Stroebe and Schut suggest most people will move back and forth between loss-oriented and restoration-oriented activities.
Please do bear in mind that these are summaries of wider books and papers and often feelings cannot be reduced to a simple list. Instead, these ideas may be helpful as a tool to assist your understanding of yourself and your thoughts and reactions. They can give you the vocabulary identify what you are feeling. You may be able to notice some of the aspects described or perhaps not be able to name anything of what you are feeling right now whatsoever. This is ok. Having many strong feelings at different times can be exhausting and not easy to make sense. There may be a temptation to avoid them and “move on” with life. However, denying the feelings is hard on the body and mind and it is important to recognise and start to process them. Some people may experience grief after an ectopic pregnancy many years after the event, perhaps triggered by a different loss.
Am I depressed?
Grief is an understandable reaction to loss and it is important to recognise that depression is more than feeling unhappy or fed up for a few days. When a person is depressed, their mood is persistently low and can affect day-to-day life. They may feel persistently sad, detached, or irritable for weeks or months.
I have lost my energy and cannot be bothered to do anything
It is common for people to lose interest in day-to-day activities and avoid social situations after an ectopic pregnancy. You may not have the attention span or care about other things, feel detached from others, and then frustrated that they do not seem to understand how you feel. If this continues for more than a few weeks, you may be depressed. It would be worth talking to your GP who may be able to help arrange some counseling or medication that could help.
I feel numb
After an emotionally overwhelming incident like an ectopic pregnancy, you may experience a sense of numbness or emotional blunting. It can be hard to figure out exactly what you are feeling. This occurs when the mind is overwhelmed and unable to process everything that has happened. As a result, the mind “shuts off” some feelings and it is common reaction. It is important to allow time to process what has happened and try to reach out to supportive people with whom you can talk.
The sense of numbness tends to reduce over time. However, if you are still experiencing this for most of the time a month after your ectopic pregnancy, we strongly suggest that you talk to your doctor/GP. This is especially important if accompanied by other symptoms such as flashbacks or anxiety.
I feel so angry!
Anger is another common response to the trauma you have suffered. You may feel angry because of what has happened, angry because you do not feel a sense of control of your fertility, and angry with others for things that they have or have not done either knowingly or unknowingly.
Even though it may be hard, it is important that to try to communicate these feelings to get them ‘off your chest’ and to help others understand. Emotions like anger can be difficult to express as they are seen as “negative”. However, these are natural emotions just like other feelings that we encounter. There are ways to cope through healthy expression and some people find art, writing, or music can be useful tools.
I feel jealous around pregnant women and feel bad about it
Discomfort and jealousy around other pregnant women or when a friend announces they are pregnant is something that we often hear about. This is usually coupled with wanting to avoid them and guilt for thinking this. These reactions do not mean that you are a “bad” or “unkind” person. While being happy for others, we are also grieving the loss of what we do not have and seeing others’ pregnancies is a stark reminder of what could have been for ourselves.
People who are recovering from ectopic pregnancy often feel shocked at these reactions. It is unexpected and unlike their “normal” selves. Anger, guilt, hatred, loathing, and a sense that it is just not fair are all common and understandable. These emotions are not a reflection on you as a person; they are as a result of the intense and heart-breaking situation that you have experienced. It can take time to realise that these feelings are normal and you are grieving for the pregnancy that you have lost. Many find it helpful to share emotions on our discussion forums safely and privately among others who understand.
I am experiencing flashbacks/nightmares
Reliving parts of your experience of ectopic pregnancy through flashbacks, nightmares or intrusive thoughts is one of the most common reactions reported following ectopic pregnancy. You may feel suddenly overcome with intense emotion or experience palpitations, feel anxious, agitated, on edge, or irritable. Some also experience a sense of being detached and numb and that the ectopic pregnancy has changed them in some negative way.
If these symptoms persist for more than four weeks and impact on your ability to carry on your daily routine, you may have Post-Traumatic Stress (PTS). There are some suggestions that it affects as many as 40-50% of women after an ectopic pregnancy. NHS Choices recommends you should visit your doctor/GP if you are still having problems about four weeks after the traumatic experience, or if the symptoms are particularly troublesome, or affecting your day-to-day activities.
When will I feel better?
There is no easy answer to this as everyone deals with emotion differently. However, we do know that grieving and its stresses pass more quickly with good self-care habits. It helps to have a close circle of family or friends and to talk about how we are feeling. If it is not easy to talk to friends and family, then the discussion forums could be invaluable. It also helps to eat a balanced diet, drink enough non-alcoholic fluids, get exercise and rest.
As time progresses, it is important to try to strike a balance between processing what has happened and continuing with your daily life and responsibilities. As the weeks pass, you may begin to feel the need to bring more routine back into your life and function with more usual activities. Having distractions can have their place in providing a different focus and being aware of this is important together with not ignoring your feelings. You may start to consider returning to work and this may bring up lots of emotions.
I am an LGBT+ person
As an LGBT+ person experiencing ectopic pregnancy, there may be a mixture of emotions that surface from not only the diagnosis itself but also combining what you have been through already in your journey.
Trying to conceive may have taken a long time , which may have involved trying naturally, through home insemination, or through a fertility clinic. You may have had additional barriers to overcome on your journey be they lack of access to funding, discrimination or understanding of your situation across health services, trying to find a donor, body dysmorphia, deciding who would possibly carry, or even prior loss. These considerations may make you feel that your ectopic pregnancy is unfair due to the added challenges you have faced. If you experience body dysmorphia and have had surgery, any physical scars might create further distress. If there was discussion in your relationship about who would carry the pregnancy, you may be feeling regret and disappointment and might be worrying that your partner could be thinking the same.
You may be lacking support in regards to you having children, from family, friends, or even professionals who feel that you should not become a parent at all – which can be incredibly distressing. The lack of support may feel more intense with your ectopic pregnancy and you may be feeling alone in your loss.
You may struggle to manage all these emotions at once and question everything you have done to this point: Why has ectopic pregnancy happened to you after everything you have already been through? Why has it been such a difficult journey? What you did wrong? Please try to remember that you have not done anything to suffer from an ectopic pregnancy, you are not to blame and ectopic pregnancy is something that can unfortunately happen to anyone.
If you have a partner, partners, or are co-parenting, you may feel that you need to support the other people within your family with the loss. This can be an added weight to carry.
I am a trans or non-binary person
If you are a trans or non-binary person, you may have had a difficult journey to become pregnant. This could have involved stopping medication that you were taking to transition, which could impact your hormones and the physical changes that were occurring for your transition. In some cases, ceasing the medication may reverse the changes your body was undergoing.
You may have experienced a lack of affirmation of your journey and possible lack of professionals around you on how best to support you which could add further stresses. Some people can also experience body dysmorphia where they feel uncomfortable with their body and this might be the case through treatment while still pregnant as the ectopic pregnancy resolves (if having medical or expectant management) or could be felt as a result of physical scars due to surgical treatment.
Some feel they do not wish to declare their identity, pronouns, or situation as they do not want to continually ‘out’ themselves all of which can lead to feelings of invisibility and further dysphoria. These additional aspects may have an impact on your mental health including depression and anxiety.