5 Ways Couples Therapy Can Help After Pregnancy Loss

Miscarriage may lead partners to feel disconnected. Couples therapy can help.

Posted October 14, 2025 | Reviewed by Gary Drevitch

Ed and Sheena were about to have sex for the first time after their third miscarriage six weeks before. Sheena had recently felt Ed being distant towards her. This made her wonder if Ed’s disappointment about their most recent loss was turning into anger . Did Ed silently blame her for their losses? After all, her body had failed to carry through the pregnancies. She hoped that the two of them getting intimate with one another that night would bring them closer together.

Further, Sheena was close to her ovulation. She had read that her chances of falling pregnant soon after a miscarriage were higher. Her wish for a child was stronger than ever. Sheena did not want to waste what she hoped was a more-than-usual fertility window. At the same time, the prospect of another pregnancy , and potentially another miscarriage, made her incredibly nervous.

Sex happened that night, but it was brief and mechanical. After it was over, Sheena asked Ed if everything was ok. Ed did not answer at first. A whispered “no,” with Ed’s voice barely coming out, set off Sheena’s alarm bells. After a fair bit of prompting, Ed finally admitted that the sex had felt “transactional”. He thought Sheena had only initiated it because she was desperate for a baby.

Hearing Ed’s words and resentful tone felt like a slap in Sheena’s face. She felt rejected and misunderstood. Of course, she was desperate for a child. Wasn’t Ed? However, Sheena was more desperate to have Ed's affection at that exact moment. What a shame that he was so emotionally cut off from her.

Ed thought of running behind Sheena as she rushed out of the room crying, but did not. The heaviness of his thoughts was paralysing. Ed could not shake the feeling of being “used” during sex. A childhood memory of his mum using him to offload after arguments with dad unexpectedly surfaced. A familiar niggling feeling of not being good enough followed. “I am certainly not a good partner for Sheena right now”, he thought guiltily.

5 things couple therapy after pregnancy loss can do

When a couple starts growing apart following a pregnancy loss, professional help may be worthwhile. Couple therapy can be of benefit to partners such as Ed and Sheena in at least five different ways:

Explore and validate each partner’s responses. Incongruent grief after miscarriage, as Ed and Sheena experienced, can create a disconnect between the two partners. (I explain more about incongruent grief here. ) Each partner’s investment in a baby lost early in pregnancy may be different, with the gestational partner often, but not always, developing a stronger attachment early on. The use of language may be dissimilar too. Do both partners call this new life a “baby”? Or did it feel too early for that? In therapy, it is about respectfully witnessing each other’s grief and responses to an early loss without judging it.
Help both partners feel equally seen and involved. If there is a sense that both partners are not evenly affected by the loss, then the two may adopt opposite positions; one needs support, and the other is offering support. In this couple, Ed seemed to have taken the position of offering support to Sheena. However, this dynamic has not worked well for them. This can happen when one partner over-relies on the other and easily feels betrayed when their other half does not understand how they feel. The partner who is there to support can easily feel overlooked and neglected, or helpless for not being successful at consoling their partner. Couples counselling will aim to change this dynamic by recognising both partners’ need to support and feel supported, and encouraging partners to move away from polarised roles.
Explore and change unhelpful emotions and communication patterns. Guilt and anger are common emotions following a miscarriage. They can sometimes manifest as self-blame. This was evident in Ed feeling “not good enough” as a partner.

The lack of clear answers about the causes of miscarriages can exacerbate such feelings. If we don’t blame ourselves, we may blame our partner, even without intending to do so: It's human instinct to want to hold someone accountable when things go wrong.

Underneath the guilt and anger, though, there may be profound shame for not feeling like a "real" man or a woman. Sheena, for example, feared that there was something profoundly wrong with her body that prevented the pregnancies from continuing.

A therapist could help partners name these feelings and unpack hidden fears. Further, in therapy, partners can understand how such feelings are linked to raw childhood memories, like that of Ed’s mother offloading to him. Encouraging partners to communicate such feelings and explain what they need from each other in a safe therapeutic space can foster a close bond for the couple, instead of growing distance.

Facilitate shared opportunities to grieve. Even if both partners were not affected equally by grief, it could be of help to have shared ways to remember the little creature lost in pregnancy. This may include finding a grieving ritual that both partners feel comfortable participating in. It could also be about selecting or creating a grieving object commemorating this early life. Sadness brings us closer and evokes compassion for our partner. Ed and Sheena may have missed such an opportunity. When partners are stuck, a therapist could help them find ways to grieve together.
Moving forward in the same direction. Ed and Sheena were not clear with each other about how quickly they wanted to move with trying to conceive again. Sheena wanted to throw herself into it while Ed wanted a break, but could not bring himself to tell her. In therapy, partners are invited to talk candidly about how each would like to move forward in their fertility journey. Are they both ready to try again to conceive? Or does one of them want to slow down? Couple therapy may also focus on helping partners take difficult decisions together. Such decisions could include investigations or medical interventions, financial pressures, and practical issues. And sometimes a couple may have to decide that they have reached the end of their fertility journey.

Grief is life-transforming. Learning to be with each other’s grief about pregnancy loss could deepen a couple’s bond. However, this does not always happen, or does not happen without first going through a bumpy road. Couple therapy can help partners cope with the adversity of miscarriage and subfertility and grow stronger together.

To find a therapist, visit the Psychology Today Therapy Directory .

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Venetia Leonidaki, D.Clin.Psy., is a Consultant Clinical Psychologist with a particular interest in grief and addiction and a person with lived experience of perinatal loss.

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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.