When the Bough Breaks: Resources for Overcoming Perinatal Loss

Sad woman with comforting hands on shoulderOctober is Pregnancy and Infant Loss Remembrance Month. Therefore, it seems a pertinent time to discuss the difficult topic of perinatal loss.

Just what is perinatal loss? Perinatal loss is the death of an infant during pregnancy or soon after. It includes miscarriage, stillbirth, and neonatal death.

Miscarriage is the most common of this form of loss, which is defined as “the spontaneous loss of a fetus before the 20th week of pregnancy.” A few statistics which may be illuminating:

  1. 10-20% of all known pregnancies result in miscarriage.
  2. More than 80% of miscarriages happen before the 12th week of pregnancy.
  3. 85% of women who have had a perinatal loss go on to have a successful pregnancy.
  4. Women (and men) can develop perinatal depression following a pregnancy/infant loss.

Other perinatal losses include stillbirth (defined as “fetal death after 20 weeks gestational age”) and neonatal death (where the infant dies within 28 days following a live birth).

Parents experiencing such devastating loss certainly endure what can be entitled “disenfranchised grief”; that is, a grief which can feel difficult to validate by community on the surface due to the stigma or socio-cultural discomfort of the nature of the loss. Grieving parents struggle with isolation and the potential to develop perinatal depression following such profound loss. Therefore, it is of paramount importance for parents to receive support in the form of psychotherapy, support groups, grief rituals, and bibliotherapy.

Studies show that a strong support network contributes significantly in reducing isolation (grief support groups for bereaved parents will be listed at the end of this article). The couple dyad is also at risk for conflict due to enormity of the loss; therefore it is recommended that couples receive counseling to strengthen their relationship and communication skills. Each member in the couple may have different styles of mourning. Rituals of remembrance considered helpful to the grieving process include: including memory boxes, naming the baby, tapping into spirituality, religious rites/practices, embracing traditions of the family/culture, see/touch/feel baby, photos, funeral, mementos, and journaling.

For those who have not experienced such magnitude of heart-breaking loss, it can be difficult to understand how deeply challenging the ensuing grief process manifests for parents who have lost a child. Bereaved parents can be bewildered with well-intended (but not helpful) comments from concerned friends/family who might say comments such as: “Oh, it’s not a big deal. You can get pregnant again.” or “It was not meant to be; the child would have had a medical problem anyway.” Such comments can further exacerbate a sense of isolation and create a feeling of invalidation of the loss. Parents need a listening ear in which they can feel safe to express themselves with nonjudgmental support.

As mentioned earlier in the article, parents who endure perinatal loss are at significant risk for postpartum depression. Women experience hormonal fluctuations after a miscarriage or pregnancy loss, as well as following a neonatal death. Studies show that hormonal fluctuations linked with reproductive events, combined with other factors, can contribute to perinatal depression/anxiety. When grief is factored into the equation, it is clear that such individuals are in need of screening to assess for depression and referral to trained perinatal psychotherapists and support groups.

Many resources are available on the Internet, which include support groups, bibliographies, medical information, blogs, journal/remembrance items, resources for perinatal providers. Please see the following for recommended websites regarding support for perinatal loss:

Postpartum Support International: www.postpartum.net –the world’s largest non-profit dedicated to women’s mental health during the reproductive years; resources for perinatal providers and support groups
Healing Hearts: www.babylosscomfort.com – resources, support groups for perinatal loss
Compassionate Friends: www.compassionatefriends.org – support groups for perinatal loss
SHARE Pregnancy and Infant Loss: www.nationalshare.org – grief support after death of child; excellent bibliography
MISS Foundation: www.misschildren.org – grief support groups listed nationally

Related Articles:
Even Dads Can Get Postpartum Depression
Creatively Moving From Grief into Hope and Renewal

© Copyright 2011 by Andrea Schneider, LCSW. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Carolyn

    October 26th, 2011 at 2:16 PM

    I can’t even begin to imagine the loss and the heartache that parents must feel either with a perinatal or a neonatal loss. You have so many hopes and dreams for you and this baby together and in a moment it is taken away. It must be so difficult to get through something like this happening. I hope that the hospitals and doctors where these babies and their parents are treated offer lots of grief counseling to help them through something like this because that would be awfully hard to manage on their own.

  • Nicky Bailey

    October 26th, 2011 at 3:52 PM

    What takes my breath away after a miscarraige is how insensitive people can be. My sister was told by her best friend that “it wasn’t a real baby yet anyway” after she lost hers at nine weeks. WTH?! The coldhearted words that came out of people’s mouths stunned me and they didn’t have a clue they were being offensive.

  • Wilma Armstrong

    October 26th, 2011 at 5:14 PM

    @ Nicky Bailey:
    Oh, that is so, so awful. Your poor sister! My heart goes out to her for having to endure her loss and that awful comment. If it had been my sister she’d been talking about I would have slapped that stupid woman for that the first time I saw her.

    The mother has still lost her child and that loss is agonizing, no matter what period of gestation it occurs at. Why is that so hard to understand? Stupidity knows no bounds unfortunately.

  • momofone

    October 26th, 2011 at 5:29 PM

    When I miscarried at eleven weeks I heard some of those things, particularly from older women in my family about how the baby must have been disabled. They say it in this condescending manner that sounds to me as if they are saying I had a lucky escape and should be dancing in the streets. It’s incredibly, incredibly hurtful.

    So what if the child may have been disabled? Did I say I wouldn’t want the baby if it were? That I’d be happier to lose the baby than carry it full term and care for it? It was MY baby. I would have liked to have had the chance to make a choice instead of Nature deciding for me.

  • Fred

    October 26th, 2011 at 9:08 PM

    Losing a child like this can be so devastating for the parents.A lot of us consider having a child as a milestone in both our lives and in our marriage.When something of this nature occurs it is not only taking the child away from the parents but is also negatively impacting their lives and marriage.

    This could well lead to a tense situation where both the parents are vulnerable to having problems with each other too.So effective communication is one thing that really requires concern.

  • Nelson

    October 27th, 2011 at 11:44 AM

    The wife had a miscarriage years ago.Looking back at it,it definitely wasn’t the best of times we have shared and it seemed like it would never end.But things do turn around and having two very energetic teens at home does fix all that.All those couples who are wondering if it will ever be fixed-please read point number 3 mentioned in this article-“85% of women who have had a perinatal loss go on to have a successful pregnancy.”

  • astrid escobar

    October 27th, 2011 at 11:56 PM

    If you don’t know what to say to a woman who’s had a miscarriage, simply say you’re sorry for their loss and leave it at that. Offer to be there for them if they need to talk about it, and only if you can say that part and mean it.

    The mother is not looking to you for answers on why it happened. She is looking to you to acknowledge her pain and that that little spark of life was important enough not to be brushed aside casually or ignored as if it never existed. So most of all, don’t stay silent. Offer your condolences and support the same as you would for any other bereavement. Because that’s precisely what it is.

    To all the ladies who have suffered this, I am sorry for your loss.

  • Charlene Crosby

    October 28th, 2011 at 12:40 AM

    My mother had three miscarriages in the five year age gap between my older brother and I. Each time my dad clammed up and wouldn’t talk about them after it happened. I can’t imagine how hard it would be to not have your spouse’s ear to help you through the miscarriage and afterward.

    I never found out why he did that because neither did she. Her guess was that he worried about there being a genetic problem on his side and that it was his fault. (My dad had a cousin with Down’s Syndrome who was in an institution and he apparently lived in fear of having a Down’s baby. Bear in mind this was in the late 1950’s when a whole different mindset existed).

    I sincerely hope modern day husbands show more compassion, patience and support. And we need to remember that they must be grieving too.

  • Selena

    October 29th, 2011 at 6:40 AM

    One of the biggest problems is that most of us have no idea how to help someone through a loss like this. You don’t know what to say or do to make the family feel better or to help them deal with the loss. So I think that in many cases the friends retreat for fear of doing or saying the wrong thing.

  • PAuLA

    October 30th, 2011 at 5:47 AM

    While it must be difficult to experience a miscarriage it cannot even possibly compare to losing a child after a live birth. Must be one of the most devastating things that new parents would have to face and yet it is a reality for many each and every day. You would have to have a really strong network of support to make it through such a loss as this. And @ Selena I would think that I would have to be the worst kind of friend ever to retreat and go away just at the exact time that some one needed me the most.

  • Andrea Schneider

    December 5th, 2011 at 7:52 AM

    Thanks for the comments all. My healing wishes to any and all who have sustained a perinatal loss. I hope the resources at the end of the article are of some help in finding local support groups and bibliotherapy lists. My best to you, Andrea

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