At first Sandra van Eden thought she was going mad. She would cry when she didn't want to and started acting completely out of character.

After her second miscarriage, she leaped on to the bonnet of the car whose driver had pinched her parking space, screaming and cursing at the young men inside.

"This wasn't me at all. I was a teacher, I was used to being in control," she says.

"They just laughed at me and walked off ... If someone had told me I was grieving, I would have just been more gentle with myself."

One in five pregnancies in New Zealand end in miscarriage and about 80 per cent happen before 12 weeks' gestation.

Dr Hilary Liddell, founder of the Recurrent Miscarriage Clinic at National Women's Hospital, says that after the age of 40 the chances of a miscarriage double.

Ms van Eden, now the mother of three, after an operation to fix a deformed uterus, had three miscarriages in the first three years of the 1980s.

At the time there were no support groups (she set up Miscarriage Support Auckland in 1985) and like most women then, she was told by doctors, "Never mind dear, go home and try again".

Friends and family tried to be helpful, but often their comments - "it was only 10 weeks, it wasn't a real baby" - minimised the loss.

Her husband didn't know how to cope with her grief when it lasted longer than the week the doctor told him to expect. "You don't know who you are grieving for and society doesn't legitimise your grief. There is no funeral, no cards, no flowers."

Lois Tonkin, a Christchurch-based grief counsellor, who works with women who have had miscarriages or suffered a stillbirth, says 20 years ago the attitude was that people got over a stillbirth more easily if they did not see, touch or hold their baby. Sometimes women did not even know if it was a boy or girl.

Ms Tonkin remembers one woman meeting her at the front door with a ragged funeral director's bill, saying it was all she had to prove there must have been a baby.

While attitudes have changed - people now often take their dead baby home, take photos and hold funeral services - many women who have experienced a stillbirth or miscarriage, in particular, believe their loss and grief is not always acknowledged.

Ms Tonkin, who has written a book, Still Life, says women often question what's wrong with them if they haven't been able to carry a baby fullterm.

They can feel singled out and question if they are being punished in some way. They may feel a sense of failure, or anger and blame towards the medical profession.

Vonney Allan, co-ordinator of Miscarriage Support Auckland, says younger people often don't realise they are grieving and can feel as if they are going mad. Talking to someone who has had a similar experience is often the best support.

Some women who have had a miscarriage or stillbirth feel a desperate urge to become pregnant again, but others find it difficult.

Women who have had three or more miscarriages or two miscarriages late in their pregnancy can be referred to National Women's Recurrent Miscarriage Clinic, which monitors up to 150 pregnancies a year.

Grieving process important

Advice for women and their families coming to terms with a miscarriage or stillbirth.

* Acknowledge your loss and accept you will need time to grieve.

* Talk to other people who have had a similar experience - support groups may be helpful.

* Get information about grieving from your doctor, hospital or library. Some books have been targeted especially at children.

* Make use of strategies to remember the baby, such as visiting their grave, planting a tree or having their name as a password on your computer.

* Tell other children honestly what has happened, don't make it mysterious or they may start thinking it's their fault. Encourage them to express their feelings and tell them how you feel but reassure them you will be okay. Include children in the rituals of remembering.

* Useful contacts: SANDS (Stillbirth and Newborn Death Support) ph 270 0895 or 278 8095. Miscarriage Support Auckland Inc. ph 378 4060 or 360 4034.

Miscarriage Support Auckland Inc