Revisiting Support for Those Affected by Perinatal Loss

October is National Pregnancy and Infant Loss Awareness Month. Did you know that most sources report one in four pregnancies results in perinatal loss? That’s a pretty high percentage of people impacted by this devastating loss, be it due to miscarriage, stillbirth, ectopic pregnancy, or another form of neonatal death. But our society doesn’t talk about it. Death is a difficult subject for most to discuss. Death of a child is even more agonizing.

Let me do my part to break that taboo by sharing a little of my own story of perinatal loss. I am a psychotherapist who specializes in women’s reproductive mental health (including pregnancy, childbirth, perinatal loss recovery, infertility, and perimenopause support).

I am a mother as well. I first became acquainted with perinatal loss with the initial ultrasound of my second pregnancy. I had anticipated a planned, singleton pregnancy. During the first trimester, an ultrasound was performed during which the doctor found evidence of two sacks in my uterus. One sack contained the lively, wiggly embryo of my son, Graham, and the other sack was, astonishingly, empty.

According to my doctor, I had what was called “vanishing twin syndrome.” I had never heard of this. Apparently it is quite common in a twin pregnancy:one twin simply not developing. It essentially miscarries, absorbed into the endometrial lining, while the other twin goes on to develop normally. According to studies, many of us born as singletons had a twin that “vanished.” But prior to the use of ultrasound, the frequency of this type of pregnancy was unknown. My doctor apparently experienced this herself with her third pregnancy.

I was dumbfounded. I was simultaneously thrilled about the notion of meeting my little Graham for the first time (although I didn’t yet know his gender) and surprised at my sudden sadness for the loss of his twin, a little one I would never meet. I wasn’t expecting twins initially, and I fully anticipated seeing the wiggly embryo of one child. However, with the image of the empty sack on the ultrasound, I felt like I had been punched in the stomach. It was the beginning of my own perinatal loss grief work.

Not only is there the loss of the child, but there is the loss of dreams, hopes, and a future for this new life.

The process of perinatal loss grief recovery is as unique as the individual(s) experiencing the grief. And yet there are some common factors woven into the recovery process. For one, losing a child to perinatal loss—whether by miscarriage, stillbirth, etc.—is one of the most devastating losses an individual can endure. Not only is there the loss of the child, but there is the loss of dreams, hopes, and a future for this new life.

Women are particularly vulnerable to perinatal depression or anxiety due to the hormonal upheaval experienced following childbirth/miscarriage. Men can also experience depression or anxiety following the loss of a baby, but they are more likely to isolate or immerse themselves in work-related activities as part of their healing process.

Although one can experience grief without depression, typically parents enduring the loss of a baby will manifest symptoms that can be signs of depression, including insomnia, reduced appetite, isolation, profound sadness for more days than not, overwhelming anxiety, panic attacks, traumatic reliving of the loss event, and numbness. The grief cycle often begins with shock and numbness, and as that period wears off, the raw emotions of profound sadness and anger ensue. Eventually parents will accept and synthesize their loss, incorporating a devastating life chapter into renewed hope in the present and for the future.

Helpful interventions/resources/support for those experiencing perinatal loss:

• Attend individual/couple/family counseling with a skilled, trained psychotherapist who specializes in new families/reproductive mental health.
• Attend an in-person or online support group specific to perinatal loss.
• Journal or use other creative expression (art, writing, dance) to process grief.
• Seek out social supports who are compassionate, non-blaming and non-judging (could be friends, family, neighbors, or spiritual community).
• Self-care—set limits with any activities that are not healing, and say no to unnecessary obligations (including baby showers).
• Exercise to discharge stress (yoga, deep breathing, etc.).
• Have a trusted friend set up a “meal train” online, whereby friends and family can sign up to bring your bereaved family dinners.
• When ready to read about perinatal loss, see below for some titles that may be of comfort.

Know that you will heal and the pain will lessen. You will never forget your baby, but you will walk through the grief and move into a new chapter with acceptance. There is no deadline for grief, as it is cyclical. Certain times of year may be more vulnerable than others (holidays, anniversaries of birth date and death date, etc.). Be sure to set up psychotherapy booster sessions around those times.

Take some time off from work to heal and boost your recovery process, if needed. On the other hand, if staying busy with structure helps, then keep that predictability in place.

Keep in mind that one in four pregnancies results in perinatal loss. That’s a lot of people. Display compassion for your friend or family member and be a listening ear. Being preachy and saying things such as “It wasn’t meant to be” or “You can have more children” are not only condescending, but unhelpful as well. Instead, give your loved one a hug, tell them you love them, and be a listening ear. Let them share their story and be comforted by your presence. Let your friend/family member “narrate” their story to you, releasing their sadness. Refer your friend to a skilled perinatal psychotherapist.

Please utilize the following resources for the bereaved facing perinatal loss:

• Covington, Sharon. Silent Birth: When Your Baby Dies, Fairview Press, 2003.
• Davis, Deborah. Empty Cradle, Broken Heart: Surviving the Death of Your Baby, Fulcum Publishing, 2000.
• Freda, Margaret Comerford. Miscarriage after Infertility: A Woman’s Guide to Coping, Fairview Press, 2003.
• Gilbert, Kathleen, and Laura Smart. Coping with Infant Loss: The Couple’s Healing Process, Brunner/Mazel Publishers, 1992.
• Ilse, Sherokee. Empty Arms: Coping with Miscarriage, Stillbirth and Infant Death, Wintergreen Press, 2008.
• Klein, Darcie. To Full Term: A Mother’s Triumph over Miscarriage, Berkeley Books, 2007.
• Allen, Pat. Art Is a Way of Knowing: A Guide of Self-Knowledge and Spiritual Fulfillment Through Creativity, Shambala, 1995.
• Malchiodi, Cathy. The Art Therapy Sourcebook, McGraw-Hill, 2006.
• Malchiodi, Cathy. The Soul’s Palette: Drawing on Art’s Transformative Powers for Health and Well-Being, Shambala, 2002.
• McNiff, Shaun. Art as Medicine, Shambala, 2004.

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Andrea Schneider, LCSW, Postpartum Depression Topic Expert Contributor

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