Men and women tend to grieve differently, with women wanting to discuss the loss and men tending to want to "close up and go play golf," Keefe said, though there are always exceptions.
For couples going through infertility treatment, who may have already heavily invested themselves in the pregnancy financially and emotionally, the loss can be especially difficult to bear.
"The study provides evidence scientifically of what a lot of us sensed was an issue, which is that following a major disappointment of a miscarriage or stillbirth, that marriages can fall apart," said Keefe, a fertility specialist who has also trained as a psychiatrist.
After the miscarriage, Becker had trouble sleeping, became depressed and wanted to "talk about what had happened to anyone who'd listen," she said.
Though she and her husband of 22 years never seriously considered divorce, "it did affect our relationship," Becker said.
Gradually, Becker found her own way of coping. Now 44, she started a Web site, miscarriagememories.com, where she offers support to other women going through similar loss and sells silver charms to memorialize the baby that could have been.
"People e-mail me all the time and say, 'Thank you for telling me I am not crazy for feeling this way,'" Becker said. "I would rather have the baby, but if I couldn't have that, I am happy that something positive has come out of this."
The American Pregnancy Association has more on miscarriage.
SOURCES: Katherine Gold, M.D., M.S.W., M.S., assistant professor, department of family medicine and department of obstetrics and gynecology, University of Michigan, Ann Arbor; Wendy Becker, mother, Highlands Ranch, Colo.; David Keefe, M.D., chairman, obstetrics & gynecology, New York Universi
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