Miscarriage matters – Why leave and support are essential
Every year about 300 women miscarry in Malta and Gozo - that’s 300 broken hearts… 600 when we include the fathers. The government recently announced it will be looking into the introduction of paid leave for employees who suffer a miscarriage. Currently, Maltese law does not provide for any special leave in case of miscarriages. An employee who suffers a miscarriage can apply for sick leave. Woman Unclouded caught up with fertility counsellor Danielle Scerri Azzopardi, who is organising miscarriage support groups, to understand what women go through when they miscarry and why granting them leave to grieve and heal is essential.
What inspired you to start the miscarriage support groups?
Working in the field of IVF, I have encountered many patients who have experienced a miscarriage both before undergoing IVF and, at times, after an embryo transfer. Through my sessions, it became evident that many individuals felt isolated in this journey.
While a miscarriage is unfortunately common, many of my patients had never met someone who had gone through a similar experience, often because not everyone feels comfortable discussing their loss.
Recognising this gap, I previously collaborated with SOS Malta to establish an IVF group therapy program, which continues to run today. This initiative led to discussions about launching a miscarriage support group, particularly given the lack of such resources in Malta and the crucial need for open conversations about pregnancy loss.
When individuals are provided with a supportive environment and surrounded by those who truly understand their experience, they feel more at ease expressing their thoughts and emotions.
Fortunately, last year, the Malta Midwives Association reached out to me to initiate a miscarriage support group, further reinforcing the importance of creating a safe space for those affected by pregnancy loss.
What are the main issues that women face when they experience a miscarriage?
Every individual experiences a miscarriage in a different way, yet there are common emotional challenges that many face. Some of the most frequent concerns include questioning whether they did something to cause the miscarriage or if it could have been prevented. Many express feelings of guilt, believing they were unable to protect or save their baby.
“One of the greatest challenges is the expectation to resume life as if nothing happened, despite the profound emotional toll.”
- Danielle Scerri Azzopardi
One of the most prevalent fears, however, is uncertainty about the future. The anxiety of experiencing another miscarriage can be overwhelming, and even for those who conceive again, pregnancy is often accompanied by persistent fear and anxiety. Many only find a sense of relief once their baby is safely in their arms.
How does a miscarriage impact them physically, emotionally, and psychologically?
For many, experiencing a miscarriage is life-altering. As with any traumatic event, while healing is possible, the emotional scar remains, and individuals are often surrounded by triggers that remind them of their loss. Miscarriage primarily impacts a person emotionally and psychologically, as it involves navigating the complex stages of grief, which take time to process.
One of the greatest challenges is the expectation to resume life as if nothing happened, despite the profound emotional toll. The reality is that a miscarriage fundamentally shifts a person’s sense of self. They do not return to who they were before - instead, they become a new version of themselves—one who has endured loss and must learn to navigate life with the emotional triggers that follow.
There are also significant physical challenges associated with a miscarriage. Common symptoms include bleeding, cramping, fatigue, and mood swings due to hormonal fluctuations. Some individuals experience disruptions in their menstrual cycle, changes in appetite, or, in more severe cases, develop depression. Recognising the mental health impact of miscarriage was one of the key reasons for establishing this support group.
I strongly encourage anyone who has experienced a miscarriage to reach out for support as soon as possible. No one should have to navigate this journey alone, and we are here to provide the understanding and care that is so often needed during this difficult time.
Are there differences when it comes to at what stage in the pregnancy they miscarried?
When a miscarriage occurs in the first trimester, the body typically recovers relatively quickly. In many cases, the miscarriage happens naturally without the need for medical intervention, though some individuals may require a Dilation and Curettage (D&C) procedure to remove remaining pregnancy tissue.
“Each stage of pregnancy loss presents its own unique challenges, but regardless of when it occurs, losing a baby is always a deeply painful experience.”
In the second trimester, a miscarriage tends to be physically more intense, often involving heavier bleeding and stronger cramping. Medical intervention is more common at this stage, and because the body has been producing higher levels of pregnancy hormones, the post-miscarriage adjustment period can take longer. This hormonal shift may lead to increased mood swings and heightened emotional distress.
During the third trimester, a medical procedure is required to induce labour, making the experience physically and emotionally comparable to childbirth. However, the profound grief of leaving the hospital without a baby makes recovery particularly devastating. Many individuals describe it as giving birth but without the joy that typically follows. The physical and emotional toll at this stage is immense, and extensive support is often necessary to process the loss and begin healing.
Each stage of pregnancy loss presents its own unique challenges, but regardless of when it occurs, losing a baby is always a deeply painful experience.
What type of support do they feel they need?
Many of my patients have found that one of the most helpful aspects of coping with miscarriage is simply having someone to talk to, someone who can truly empathise with their experience and provide a safe space for them to process and express their emotions.
Some individuals reach out for support immediately after their loss, while others need time to grieve privately before seeking help. In certain cases, I have taken the initiative to check in with them, gently reminding them that I am here whenever they feel ready to talk. Providing this kind of compassionate support can make a significant difference in their healing journey.
Do you think society appreciates how truly devastating a miscarriage can be?
People have diverse opinions on this topic, making it difficult to answer with a simple yes or no. One important lesson I have learned is that what matters deeply to one person may not hold the same significance for another, but that does not make anyone’s feelings any less valid.
“Whether a miscarriage occurs at five weeks or thirty weeks… the gestational age does not diminish the emotional impact of the loss.”
Rather than focusing on personal opinions, I believe society should shift its attention to understanding the individual experiencing the loss. What is causing their pain? How can we support them during this difficult time? Whether a miscarriage occurs at five weeks or thirty weeks, it was still a baby growing inside them, and the gestational age does not diminish the emotional impact of the loss.
As a society, we need to foster compassion and empathy, recognising that grief is deeply personal and experienced in different ways. Instead of passing judgment, we should offer support, allowing individuals the space to grieve in the way that feels right for them.
The government said it will explore ways to introduce miscarriage leave. Do you think this is needed?
I strongly believe that miscarriage leave is essential. Experiencing a miscarriage is a profound loss, and individuals must cope with both the physical and emotional challenges that come with it. In many ways, it is similar to grieving the loss of a loved one, whether a person or a pet, where time is needed to process emotions and begin healing.
“I would recommend naming it "special leave" rather than explicitly labelling it as miscarriage leave. Many of my patients have expressed a desire to keep their experience private, particularly in the workplace.”
That being said, I would recommend naming it "special leave" rather than explicitly labelling it as miscarriage leave. Many of my patients have expressed a desire to keep their experience private, particularly in the workplace. They often feel that not everyone understands their grief, and while colleagues may mean well, their words can sometimes be unintentionally hurtful.
Providing a more discreet leave option would allow individuals to take the necessary time to heal without the added pressure of disclosing their loss if they do not wish to.
Feel free to add anything you feel is relevant.
On a slightly different note, I would also encourage the government to establish a dedicated space within hospitals for individuals experiencing a miscarriage, separate from the obstetrics wards. Unfortunately, the current practice of placing pregnant individuals and those going through pregnancy loss in the same ward can be deeply distressing and emotionally overwhelming.
“I would also encourage the government to establish a dedicated space within hospitals for individuals experiencing a miscarriage, separate from the obstetrics wards… the current practice of placing pregnant individuals and those going through pregnancy loss in the same ward can be deeply distressing and emotionally overwhelming.”
For someone already coping with immense grief and physical discomfort, being surrounded by expectant parents can intensify their pain. Creating a designated space for miscarriage care would provide a more compassionate and supportive environment, ensuring that those experiencing loss receive the privacy and sensitivity they deserve.
On a final note, I strongly encourage anyone who has experienced a miscarriage to seek support. It is a vital part of the healing journey, providing not only emotional relief but also the opportunity to connect with others who truly understand what you have been through. Surrounding yourself with like-minded individuals can offer comfort, validation, and the reassurance that you are not alone in this experience.
Seek support
The miscarriage support sessions are held on the first Monday of each month, from 6pm - 7.30pm, at the Malta Midwives Association, 62 Office 1 Triq il-Kuncizzjoni, Msida.
The group is free of charge and open to anyone who has experienced a miscarriage or the loss of a baby, providing a safe space for individuals to share their experiences and receive emotional support.
To sign up for the support group fill in this form.
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