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The question

My wife is inconsolable after three miscarriages. What can I do?

The answer

There are a number of things that may be help your wife through this difficult and understandably emotional time.

First, resist the tendency to problem-solve. Let her know that you love and care about her, and that you want to support her as best as you can. Acknowledge that you don't fully understand or appreciate what she is experiencing, but communicate that you want to understand. Then listen to her.

Many men have a tendency to want to try to problem-solve or find a solution, but many women feel that they just need the opportunity to express what they are feeling. Being overly positive (e.g., "don't worry, next time I know things will work out") may feel invalidating to her.

Ask her what you can do that would be helpful. We all cope in different ways and need different types of support from our loved ones. Ask her what you may be inadvertently doing or saying that is unhelpful.

Ensure that you are present for any appointments that she is attending with respect to managing her health post-miscarriage, and also in terms of appointments moving forward to investigate causes of the miscarriages.

Although the rates of having one miscarriage are quite high (15-20 per cent, with the bulk of these miscarriages occurring within the first seven weeks of pregnancy), the rates do increase with previous number of miscarriages and concerns your wife may be having about the viability of future pregnancies may be a realistic yet also saddening or frightening thought.

Many women may experience a grief reaction, where they go through a number of emotional stages before they get to a stage of acceptance. These stages may include: denial that the loss has occurred; anger at having to deal with multiple losses; bargaining for the situation to be different; and sadness or depression.

Keep in mind that you may be also experiencing your own emotional reactions to this, and ensure that you are getting the support you need as well.

A number of factors impact the manner in which a woman copes with pregnancy loss: how early in the pregnancy the miscarriage occurs; the woman's age; whether there are previous children; and the number of previous losses.

These factors impact the bond a woman starts to make with her child (which is qualitatively different and often much stronger than the bond a father makes in early stages of pregnancy) and may amplify other worries, concerns or anxieties the woman has both about her fertility and the viability of having another child.

At some point you both may benefit from speaking to a mental health professional, who can address if she is experiencing any clinical levels of depression or anxiety.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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